1.Research Tackling Paradigm and Technological Layout Strategies Based on Erectile Dysfunction, A Clinical Dominant Disease of Traditional Chinese Medicine
Qi ZHAO ; Yun CHEN ; Baoxing LIU ; Xuejun SHANG ; Fei SUN ; Xiaozhi ZHAO ; Zhigang WU ; Chao SUN ; Peihai ZHANG ; Wanjun CHENG ; Xing ZHOU ; Zhan QIN ; Yufeng PAN ; Weiwei TAO ; Jianhuai CHEN ; Mei MO ; Xiaoxiao ZHANG ; Xing ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):291-299
To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine,the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13,2024,the 36th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing,focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction (ED). The conference brought together leading experts from traditional Chinese medicine,western medicine,and interdisciplinary fields,facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED,researching and developing new drugs of traditional Chinese medicine,and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs,it identified key directions for future scientific layout and scientific research tackling: (1) Standardization of syndrome differentiation system of traditional Chinese medicine for ED. (2) Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. (3) High-quality clinical research guided by evidence-based medicine. (4) In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. (5) Clinical translation and application promotion of new drugs of traditional Chinese medicine. (6) Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction,key focus areas,expected objectives,and clinical value were further refined,along with the establishment of a scientifically sound priority funding level evaluation system. Therefore,building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine,this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management,effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout, research and development decision-making in new drugs of traditional Chinese medicine,research topic planning,and clinical guideline formulation.
2.Influencing Factors of Depression in Patients with Postoperative Ovarian Cancer
Jialiang YAO ; Long ZHANG ; Jianhui TIAN ; Ze LIU ; Yun YANG ; Yiyang ZHOU ; Minghua LI ; Wang YAO ; Wenfei SHI ; Xinyi LU ; Pan YU ; Enchao CONG
Cancer Research on Prevention and Treatment 2026;53(5):349-359
Objective To explore the prevalence of depressive symptoms in postoperative patients with ovarian cancer and to analyze its influencing factors from multiple dimensions, including clinical characteristics, psychological factors, and laboratory indicators. Methods A cross-sectional study was conducted, which enrolled 235 postoperative patients with ovarian cancer. Depressive status was assessed using the patient health questionnaire, and the demographic, pathological, and medical record data of the patients were collected using the generalized anxiety disorder scale, Pittsburgh sleep quality index, European organization for research and treatment of cancer quality of life questionnaire core 30, and ECOG performance status score. Peripheral blood tumor marker (CA125), routine blood test, lymphocyte subsets, and serum cytokine levels were measured. Univariate and multivariate binary logistic regression analysis were used for statistical analysis. Results The prevalence of depression in postoperative patients with ovarian cancer was 39.15% (92/235). Univariate analysis showed that ECOG score ≥ 2 points, pain, anxiety, poor sleep quality, low quality of life, low life satisfaction, tumor recurrence, six or more cycles of chemotherapy, as well as higher levels of CA125, NLR, and NAR, and lower hemoglobin levels were significantly associated with depression (all P<0.05). Multivariate binary Logistic regression analysis showed that anxiety (OR=1.975, 95%CI: 1.231-3.170), sleep efficiency (OR=4.181, 95%CI: 1.211-14.43), sleep latency (OR=34.806, 95%CI: 4.258-284.542), ECOG performance status score, cognitive function (OR=0.918, 95%CI: 0.868-0.97), and life satisfaction were independent risk factors for depression (all P<0.05). Laboratory indicators were not independent influencing factors in the multivariate Logistic regression model. Conclusion Depression in postoperative patients with ovarian cancer is influenced by physiological, psychological, and social factors. Clinical management should focus on patients with anxiety, sleep disorders, poor physical condition, and low life satisfaction, and a comprehensive prevention and treatment strategy centered on psychological intervention and taking into account symptom management and social support should be implemented.
3.Diagnostic value of RART and LDT in determining the affected semicircular canal for the HSC-BPPV.
Yanning YUN ; Huimin CHANG ; Pan YANG ; Juanli XING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):319-323
Objective:To evaluate the utility of the Rapid Axial Roll Test (RART), Supine Roll Test (SRT), and Lying-Down Test (LDT) in determining the affected semicircular canal in cases of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods:A total of 330 patients diagnosed with HSCBPPV from September 2022 to September 2023 were collected and divided into three groups based on the different positional tests received: ①SRT Group, ②LDT+SRT Group, ③RART+SRT Group. The trial was divided into two stages: LDT/RART for patients in the first stage, and SRT for patients in the second stage. The elicitation rate of nystagmus among the three groups was compared to evaluate the accuracy in determining the affected semicircular canal in HSCBPPV. Results:Nystagmus was elicited in 84.55% (279/330) of the patients by positional tests. The elicitation rate of nystagmus in the RART+SRT/LDT group was 94.55% (104/110), in the LDT+SRT group it was 84.11% (90/107), and in the SRT group it was 69.91% (79/113). The differences among the three groups were statistically significant (χ²= 23.88, P<0.001). In the ② and ③ groups, there was a statistically significant difference in the elicitation rate of nystagmus between stage Ⅰ (patients with LDT or RART) (χ²=43.842, P<0.001). SRT was performed in the stage Ⅱ, and there was a statistically significant difference in nystagmus extraction rate between the two groups (χ² =4.690, P=0.030). The difference in the proportion of agreement between stage Ⅰ(LDT or RART) and stageⅡ (SRT) in determining the affected side of the semicircular canal was also statistically significant (χ² =40.502, P<0.001). For patients with a consistent diagnosis of the affected semicircular canal, the difference in cure rate was not significant (P=0.149). The Kappa statistic indicated substantial agreement between RART and SRT in terms of eliciting nystagmus (agreement 96.36%, Kappa = 0.730, P<0.001). Conclusion:RART and SRT show a high degree of agreement regarding the elicitation rate of nystagmus. RART is simple and safe, and it can effectively induce the characteristic nystagmus of HSC-BPPV, accurately identify the responsible semicircular canal and provide a more optimized examination protocol for clinical practice in HSCBPPV.
Humans
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Semicircular Canals/physiopathology*
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Benign Paroxysmal Positional Vertigo/diagnosis*
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Female
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Male
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Middle Aged
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Nystagmus, Pathologic/diagnosis*
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Vestibular Function Tests/methods*
;
Aged
;
Vertigo/diagnosis*
;
Adult
4.Network Pharmacology and Experimental Verification Unraveled The Mechanism of Pachymic Acid in The Treatment of Neuroblastoma
Hang LIU ; Yu-Xin ZHU ; Si-Lin GUO ; Xin-Yun PAN ; Yuan-Jie XIE ; Si-Cong LIAO ; Xin-Wen DAI ; Ping SHEN ; Yu-Bo XIAO
Progress in Biochemistry and Biophysics 2025;52(9):2376-2392
ObjectiveTraditional Chinese medicine (TCM) constitutes a valuable cultural heritage and an important source of antitumor compounds. Poria (Poria cocos (Schw.) Wolf), the dried sclerotium of a polyporaceae fungus, was first documented in Shennong’s Classic of Materia Medica and has been used therapeutically and dietarily in China for millennia. Traditionally recognized for its diuretic, spleen-tonifying, and sedative properties, modern pharmacological studies confirm that Poria exhibits antioxidant, anti-inflammatory, antibacterial, and antitumor activities. Pachymic acid (PA; a triterpenoid with the chemical structure 3β-acetyloxy-16α-hydroxy-lanosta-8,24(31)-dien-21-oic acid), isolated from Poria, is a principal bioactive constituent. Emerging evidence indicates PA exerts antitumor effects through multiple mechanisms, though these remain incompletely characterized. Neuroblastoma (NB), a highly malignant pediatric extracranial solid tumor accounting for 15% of childhood cancer deaths, urgently requires safer therapeutics due to the limitations of current treatments. Although PA shows multi-mechanistic antitumor potential, its efficacy against NB remains uncharacterized. This study systematically investigated the potential molecular targets and mechanisms underlying the anti-NB effects of PA by integrating network pharmacology-based target prediction with experimental validation of multi-target interactions through molecular docking, dynamic simulations, and in vitro assays, aimed to establish a novel perspective on PA’s antitumor activity and explore its potential clinical implications for NB treatment by integrating computational predictions with biological assays. MethodsThis study employed network pharmacology to identify potential targets of PA in NB, followed by validation using molecular docking, molecular dynamics (MD) simulations, MM/PBSA free energy analysis, RT-qPCR and Western blot experiments. Network pharmacology analysis included target screening via TCMSP, GeneCards, DisGeNET, SwissTargetPrediction, SuperPred, and PharmMapper. Subsequently, potential targets were predicted by intersecting the results from these databases via Venn analysis. Following target prediction, topological analysis was performed to identify key targets using Cytoscape software. Molecular docking was conducted using AutoDock Vina, with the binding pocket defined based on crystal structures. MD simulations were performed for 100 ns using GROMACS, and RMSD, RMSF, SASA, and hydrogen bonding dynamics were analyzed. MM/PBSA calculations were carried out to estimate the binding free energy of each protein-ligand complex. In vitro validation included RT-qPCR and Western blot, with GAPDH used as an internal control. ResultsThe CCK-8 assay demonstrated a concentration-dependent inhibitory effect of PA on NB cell viability. GO analysis suggested that the anti-NB activity of PA might involve cellular response to chemical stress, vesicle lumen, and protein tyrosine kinase activity. KEGG pathway enrichment analysis suggested that the anti-NB activity of PA might involve the PI3K/AKT, MAPK, and Ras signaling pathways. Molecular docking and MD simulations revealed stable binding interactions between PA and the core target proteins AKT1, EGFR, SRC, and HSP90AA1. RT-qPCR and Western blot analyses further confirmed that PA treatment significantly decreased the mRNA and protein expression of AKT1, EGFR, and SRC while increasing the HSP90AA1 mRNA and protein levels. ConclusionIt was suggested that PA may exert its anti-NB effects by inhibiting AKT1, EGFR, and SRC expression, potentially modulating the PI3K/AKT signaling pathway. These findings provide crucial evidence supporting PA’s development as a therapeutic candidate for NB.
5.Exploration of Mechanism of Huanglian Zhimutang in Treatment of Type 2 Diabetes Mellitus Based on PI3K/Akt Pathway
Lei WANG ; Yun PAN ; Lihua WAN ; Wenling TU ; Lingyong CAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):168-177
ObjectiveBased on the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, the effects of Huanglian Zhimutang on glucose and lipid metabolism disorders and hepatic insulin resistance (IR) with type 2 diabetes mellitus (T2DM) were investigated. MethodsGoto-Kakizaki (GK) rats were fed a high-fat diet to induce a T2DM rat model and then randomly divided into four groups: normal control group, model control group, metformin group (0.10 g·kg-1), and Huanglian Zhimutang group (3.60 g·kg-1), with eight rats in each group. Drug intervention was administered continuously for 8 weeks. Serum and liver tissues were collected from each group. Fasting insulin (FINS) levels were measured using enzyme-linked immunosorbent assay (ELISA), and the homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured using an automatic biochemical analyzer. Liver tissue pathology was observed via hematoxylin-eosin (HE) staining. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected using ELISA. Network pharmacology and transcriptomics sequencing were combined to analyze differentially expressed genes (DEGs) in liver tissue from the normal control group, model control group, and Huanglian Zhimutang group. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed to identify pathways affected by Huanglian Zhimutang intervention in T2DM. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to assess the mRNA expression of insulin receptor substrate-1 (IRS-1), PI3K, Akt, and peroxisome proliferator-activated receptor gamma (PPARγ) in liver tissue, while Western blot was used to evaluate corresponding protein expression levels. ResultsAfter 8 weeks of Huanglian Zhimutang intervention, typical symptoms of T2DM rats such as polydipsia, polyphagia, and polyuria were significantly alleviated, along with reductions in fasting blood glucose levels and insulin resistance(P<0.01). Histopathological results revealed that Huanglian Zhimutang effectively improved hepatic steatosis and inflammatory edema and reduced lipid vacuole formation. Biochemical tests demonstrated that Huanglian Zhimutang significantly reduced serum levels of TC, TG, and LDL-C(P<0.01). ELISA results showed that Huanglian Zhimutang effectively decreased serum concentrations of IL-6 and TNF-α(P<0.05,P<0.01). Combined network pharmacology predictions with KEGG pathway analysis of transcriptomics showed that DEGs between the Huanglian Zhimutang and model control groups were significantly enriched in the PI3K/Akt signaling pathway. Real-time PCR and Western blot results confirmed that Huanglian Zhimutang upregulated the expression of PI3K/Akt signaling pathway-related mRNAs and proteins in liver tissue(P<0.05,P<0.01), thereby reducing inflammation, alleviating hepatic lipid accumulation, and enhancing insulin sensitivity. ConclusionHuanglian Zhimutang effectively ameliorates glucose and lipid metabolism disorders in T2DM rats. Its mechanism may be related to the regulation of the PI3K/Akt pathway, which reduces inflammation and hepatic lipid deposition and relieves hepatic insulin resistance.
6.Exploration of Mechanism of Huanglian Zhimutang in Treatment of Type 2 Diabetes Mellitus Based on PI3K/Akt Pathway
Lei WANG ; Yun PAN ; Lihua WAN ; Wenling TU ; Lingyong CAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):168-177
ObjectiveBased on the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, the effects of Huanglian Zhimutang on glucose and lipid metabolism disorders and hepatic insulin resistance (IR) with type 2 diabetes mellitus (T2DM) were investigated. MethodsGoto-Kakizaki (GK) rats were fed a high-fat diet to induce a T2DM rat model and then randomly divided into four groups: normal control group, model control group, metformin group (0.10 g·kg-1), and Huanglian Zhimutang group (3.60 g·kg-1), with eight rats in each group. Drug intervention was administered continuously for 8 weeks. Serum and liver tissues were collected from each group. Fasting insulin (FINS) levels were measured using enzyme-linked immunosorbent assay (ELISA), and the homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured using an automatic biochemical analyzer. Liver tissue pathology was observed via hematoxylin-eosin (HE) staining. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected using ELISA. Network pharmacology and transcriptomics sequencing were combined to analyze differentially expressed genes (DEGs) in liver tissue from the normal control group, model control group, and Huanglian Zhimutang group. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed to identify pathways affected by Huanglian Zhimutang intervention in T2DM. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to assess the mRNA expression of insulin receptor substrate-1 (IRS-1), PI3K, Akt, and peroxisome proliferator-activated receptor gamma (PPARγ) in liver tissue, while Western blot was used to evaluate corresponding protein expression levels. ResultsAfter 8 weeks of Huanglian Zhimutang intervention, typical symptoms of T2DM rats such as polydipsia, polyphagia, and polyuria were significantly alleviated, along with reductions in fasting blood glucose levels and insulin resistance(P<0.01). Histopathological results revealed that Huanglian Zhimutang effectively improved hepatic steatosis and inflammatory edema and reduced lipid vacuole formation. Biochemical tests demonstrated that Huanglian Zhimutang significantly reduced serum levels of TC, TG, and LDL-C(P<0.01). ELISA results showed that Huanglian Zhimutang effectively decreased serum concentrations of IL-6 and TNF-α(P<0.05,P<0.01). Combined network pharmacology predictions with KEGG pathway analysis of transcriptomics showed that DEGs between the Huanglian Zhimutang and model control groups were significantly enriched in the PI3K/Akt signaling pathway. Real-time PCR and Western blot results confirmed that Huanglian Zhimutang upregulated the expression of PI3K/Akt signaling pathway-related mRNAs and proteins in liver tissue(P<0.05,P<0.01), thereby reducing inflammation, alleviating hepatic lipid accumulation, and enhancing insulin sensitivity. ConclusionHuanglian Zhimutang effectively ameliorates glucose and lipid metabolism disorders in T2DM rats. Its mechanism may be related to the regulation of the PI3K/Akt pathway, which reduces inflammation and hepatic lipid deposition and relieves hepatic insulin resistance.
7.Oxidative Stress-related Signaling Pathways and Antioxidant Therapy in Alzheimer’s Disease
Li TANG ; Yun-Long SHEN ; De-Jian PENG ; Tian-Lu RAN ; Zi-Heng PAN ; Xin-Yi ZENG ; Hui LIU
Progress in Biochemistry and Biophysics 2025;52(10):2486-2498
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline, functional impairment, and neuropsychiatric symptoms. It represents the most prevalent form of dementia among the elderly population. Accumulating evidence indicates that oxidative stress plays a pivotal role in the pathogenesis of AD. Notably, elevated levels of oxidative stress have been observed in the brains of AD patients, where excessive reactive oxygen species (ROS) can cause extensive damage to lipids, proteins, and DNA, ultimately compromising neuronal structure and function. Amyloid β‑protein (Aβ) has been shown to induce mitochondrial dysfunction and calcium overload, thereby promoting the generation of ROS. This, in turn, exacerbates Aβ aggregation and enhances tau phosphorylation, leading to the formation of two pathological features of AD: extracellular Aβ plaque deposition and intracellular neurofibrillary tangles (NFTs). These events ultimately culminate in neuronal death, forming a vicious cycle. The interplay between oxidative stress and these pathological processes constitutes a core link in the pathogenesis of AD. The signaling pathways mediating oxidative stress in AD include Nrf2, RCAN1, PP2A, CREB, Notch1, NF‑κB, ApoE, and ferroptosis. Nrf2 signaling pathway serves as a key regulator of cellular redox homeostasis, exerts important antioxidant capacity and protective effects in AD. RCAN1 signaling pathway, as a calcineurin inhibitor, and modulates AD progression through multiple mechanisms. PP2A signaling pathway is involved in regulating tau phosphorylation and neuroinflammation processes. CREB signaling pathway contributes to neuroplasticity and memory formation; activation of CREB improves cognitive function and reduce oxidative stress. Notch1 signaling pathway regulates neuronal development and memory, participates in modulation of Aβ production, and interacts with Nrf2 toco-regulate antioxidant activity. NF‑κB signaling pathway governs immune and inflammatory responses; sustained activation of this pathway forms “inflammatory memory”, thereby exacerbating AD pathology. ApoE signaling pathway is associated with lipid metabolism; among its isoforms, ApoE-ε4 significantly increases the risk of AD, leading to elevated oxidative stress, abnormal lipid metabolism, and neuroinflammation. The ferroptosis signaling pathway is driven by iron-dependent lipid peroxidation, and the subsequent release of lipid peroxidation products and ROS exacerbate oxidative stress and neuronal damage. These interconnected pathways form a complex regulatory network that regulates the progression of AD through oxidative stress and related pathological cascades. In terms of therapeutic strategies targeting oxidative stress, among the drugs currently used in clinical practice for AD treatment, memantine and donepezil demonstrate significant therapeutic efficacy and can improve the level of oxidative stress in AD patients. Some compounds with antioxidant effects (such asα-lipoic acid and melatonin) have shown certain potential in AD treatment research and can be used as dietary supplements to ameliorate AD symptoms. In addition, non-drug interventions such as calorie restriction and exercise have been proven to exerted neuroprotective effects and have a positive effect on the treatment of AD. By comprehensively utilizing the therapeutic characteristics of different signaling pathways, it is expected that more comprehensive multi-target combination therapy regimens and combined nanomolecular delivery systems will be developed in the future to bypass the blood-brain barrier, providing more effective therapeutic strategies for AD.
8.Improvement effect and mechanism of ursolic acid on allergic contact dermatitis model rats
Yang YANG ; Ying ZHANG ; Tian LIU ; Leilei PENG ; Yun PAN
China Pharmacy 2025;36(20):2537-2541
OBJECTIVE To investigate the ameliorative effect of ursolic acid on skin inflammation in rats with allergic contact dermatitis (ACD), and explore its mechanism of action based on the Notch1/hairy and enhancer of split 1 (Hes1) signaling pathway. METHODS The ACD model was established by skin application of 2, 4-dinitrochlorobenzene. Forty successfully modeled rats were randomly divided into model control group (MC group), ursolic acid low-dose group (UA-L group, 50 mg/kg), ursolic acid high-dose group (UA-H group, 100 mg/kg), and ursolic acid high-dose+Notch1 activator group (UA-H+Jagged1 group, 100 mg/kg ursolic acid+50 ng/kg Jagged1), with 10 rats in each group. Another 10 rats with only hair shedding were selected as the normal control group. Rats in the administration groups were given the corresponding dose of ursolic acid intragastrically or/and Jagged1 by intraperitoneal injection once a day for 14 consecutive days. Twenty-four hours after the last treatment, the skin inflammation status and dermatitis scores of rats in each group were detected. The levels of interleukin-6 (IL-6), IL-17 and IL-10 in serum and skin tissue were detected by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining was used to detect the pathological morphology of the skin tissue. Immunohistochemical staining and immunoblotting assay were used to detect the protein expressions of Notch1 and Hes1 in skin tissues. RESULTS Compared with the MC group, both the UA-L group and UA-H group exhibited significantly lower dermatitis scores, along with varying degrees of reduction in histopathological skin damage such as inflammatory cell infiltration. Additionally, the levels of IL-6 and IL-17 in serum and skin tissues were markedly decreased, while the levels of IL-10 were significantly increased in both groups; protein expressions of Notch1 and Hes1 were decreased significantly (P<0.05), and the improvements in the aforementioned indicators were more significant in the UA-H group (P<0.05). Jagged1 could significantly weaken the improvement effects of UA-H on the above indicators (P<0.05). CONCLUSIONS Ursolic acid may attenuate the expression of pro-inflammatory cytokines and enhance the expression of anti-inflammatory factors by blocking Notch1/Hes1 signaling pathway, thereby improving dermatitis symptoms in ACD rats.
9.Comparison of predictive accuracy and clinical applicability among four vancomycin individualized dosing tools
Shu CHEN ; Yanqin LU ; Yun SHEN ; Chang CAO ; Kunming PAN ; Xiaoyu LI ; Qianzhou LYU
China Pharmacy 2025;36(22):2822-2827
OBJECTIVE To compare the predictive accuracy and clinical applicability of four vancomycin individualized dosing tools (SmartDose, ClinCalc, Gulou, Pharmado) and provide a basis for rational clinical medication use. METHODS A retrospective cohort study was conducted, enrolling 479 adult patients who received vancomycin therapy and underwent steady-state trough concentration monitoring in Zhongshan Hospital, Fudan University (Xiamen Branch) from January 1, 2022, to June 30, 2024. The predictive accuracy of each tool was evaluated using indicators, such as mean error (ME), mean absolute error (MAE), mean percentage error (MPE), mean absolute percentage error (MAPE), the proportion of patients with an absolute percentage error (APE) of less than 30%, the 95% limits of agreement, and the overall relative percentage difference between predicted and measured values. Using indicators such as accessibility, patient management, and recommendation of multiple treatment options, the clinical panxso@163.com applicability of the tools for all patients was evaluated; using the discrepancy in accuracy between the predicted and actual measured blood drug concentrations as an indicator, the clinical applicability was assessed for patients in different renal function subgroups (hyperfunction, normal, mild impairment, moderate impairment, and severe impairment). RESULTS In terms of accuracy, SmartDose demonstrated the best overall performance with an MAPE of 46.40% and a proportion of APE <30% (46.56%). Bland-Altman analysis indicated that SmartDose had the smallest overall relative percentage difference (-7.25%), although the 95% limits of agreement were broad for all tools, with differences between the upper and lower limits exceeding 200%. In terms of applicability, all four dosing tools were freely accessible and demonstrated good availability; SmartDose and Pharmado provided the most comprehensive solutions, offering features such as patient management, multiple regimen recommendations, and drug concentration-time curve plotting. Stratified analysis based on renal function revealed that Pharmado showed optimal prediction for hyperfiltration patients (mean difference: 0.11 mg/L). SmartDose and ClinCalc showed relatively better performance in normal and mild renal impaiment (mean difference: 0.37, 0.51 mg/L and -1.13, -1.33 mg/L,respectively). SmartDose performed best in moderate renal impairment (mean difference: -2.60 mg/L). Pharmado and Gulou had smaller prediction biases in severe renal impairment (mean differences: 1.52 mg/L and -0.23 mg/L, respectively). CONCLUSIONS The four individualized dosing tools demonstrated limited accuracy in the initial prediction of vancomycin concentrations. Among them, SmartDose demonstrates the highest overall prediction accuracy and possesses comprehensive clinical management features. It is recommended that Pharmado be preferred for patients with renal hyperfiltration; SmartDose or ClinCalc can be used for patients with normal or mildly impaired renal function; SmartDose is recommended for patients with moderately impaired renal function; Pharmado or Gulou may be considered for patients with severely impaired renal function.
10.Research progress of hybrid coronary revascularization in treating coronary atherosclerotic heart disease
Xiaoyu ZHANG ; Yuanyuan PAN ; Minghuan FU ; Yun LIN ; Yiran CHEN ; Yu PENG
The Journal of Practical Medicine 2025;41(6):916-920
The incidence rate of coronary atherosclerotic heart disease(commonly referred to as coronary heart disease)remains high in China.In clinical practice,drug therapy,percutaneous coronary intervention(PCI),and coronary artery bypass grafting(CABG)are commonly employed.For patients with multi-vessel coronary artery stenosis,minimally invasive interventional therapy is often the preferred option.However,for those with multi-vessel disease complicated by comorbidities,CABG is generally recommended.Despite its advantages,PCI carries risks such as vascular restenosis,thrombosis,and other adverse events.Consequently,hybrid coronary revascularization(HCR)has emerged as an alternative approach.This paper provides an overview of coronary heart disease and re-views the advantages,applications,and patient selection criteria for HCR.

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