1.Status of Clinical Practice Guideline Information Platforms
Xueqin ZHANG ; Yun ZHAO ; Jie LIU ; Long GE ; Ying XING ; Simeng REN ; Yifei WANG ; Wenzheng ZHANG ; Di ZHANG ; Shihua WANG ; Yao SUN ; Min WU ; Lin FENG ; Tiancai WEN
Medical Journal of Peking Union Medical College Hospital 2025;16(2):462-471
Clinical practice guidelines represent the best recommendations for patient care. They are developed through systematically reviewing currently available clinical evidence and weighing the relative benefits and risks of various interventions. However, clinical practice guidelines have to go through a long translation cycle from development and revision to clinical promotion and application, facing problems such as scattered distribution, high duplication rate, and low actual utilization. At present, the clinical practice guideline information platform can directly or indirectly solve the problems related to the lengthy revision cycles, decentralized dissemination and limited application of clinical practice guidelines. Therefore, this paper systematically examines different types of clinical practice guideline information platforms and investigates their corresponding challenges and emerging trends in platform design, data integration, and practical implementation, with the aim of clarifying the current status of this field and providing valuable reference for future research on clinical practice guideline information platforms.
2.Mechanisms of Action of Dendrobium officinale Against Non-alcoholic Fatty Liver Disease Base on Its Components in Blood
Jilei ZHANG ; Lei FENG ; Yumei XU ; Heyan YAO ; Yanmei ZHANG ; Shunzhen ZHANG ; Jiao WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):168-175
ObjectiveTo investigate the preventive effect and mechanism of Dendrobium officinale (DO) on non-alcoholic fatty liver disease (NAFLD) by network pharmacology and animal experiments. MethodsDO components in blood after administration were identified and analyzed using ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry (UPLC-QE-HF-MS/MS). Network pharmacology and molecular docking methods were employed to obtain active ingredients and potential targets of DO for NAFLD control. High-fat feeds were used to replicate the NAFLD rat model. Biochemical kits were used for detecting the expression levels of blood lipids, hepatic lipids, and liver functions of rats. Hematoxylin-eosin (HE) staining and oil red O staining were employed to observe pathological changes in rat liver, and real-time fluorescence quantitative PCR (Real-time PCR) assay was performed to validate potential targets obtained from the network pharmacology analysis. ResultsA total of 13 DO components were identified in blood, including berberine, dihydrosanguinarine, and oxypeucedanin. A total of 14 potential targets were screened through network pharmacology, including Forkhead box protein O1 (FoxO1), epidermal growth factor receptor (EGFR), and insulin-like growth factor 1 (IGF-1R), involving pathways such as the advanced glycation end product (AGE)/receptor for AGE (RAGE) signaling pathway, blood lipids and atherosclerosis, insulin resistance, and FoxO signaling. The results of animal experiments showed that the NAFLD rat model was successfully replicated. After the preventive treatment with DO for NAFLD rats, the indexes of blood lipids, hepatic lipids, and liver function were normalized; lipid deposition and lesions in the liver were significantly improved; the expression level of FoxO1 mRNA in the liver was significantly reduced (P<0.05), and the mRNA expression levels of phosphatidylinositide 3-kinases (PI3K), protein kinase B (Akt), EGFR, and IGF-1R were significantly increased (P<0.05). ConclusionDO has a preventive effect on NAFLD rats, and the mechanism of action may be related to the modulation of IGF1R and EGFR targets and activation of the PI3K/Akt/FoxO1 signaling pathway.
3.Characterization and correction of astigmatism in children aged 6-12 years from urban and suburban counties of Xi'an city, Shaanxi Province, China
Junhan WEI ; Lu YE ; Qian YAO ; Rui LIU ; Guoyun ZHANG
International Eye Science 2025;25(5):831-838
AIM: To analyze the prevalence, severity, types, and correction of astigmatism in children, and provide scientific evidences for the prevention and treatment of refractive errors.METHODS: This cross-sectional study included 29 153 children aged 6-12 years from Xi'an and Lantian County, Shaanxi Province, China. Visual acuity and non-cycloplegic refraction were measured. Astigmatism was defined as an absolute cylindrical power ≥0.5 D in the right eye. Differences in astigmatism severity, type distribution, and refractive correction were analyzed across age, gender, and region.RESULTS:The prevalence of astigmatism increased with age, peaking at 11 years old(62.88%). Boys(57.10%)had a higher prevalence than girls(54.86%), and the municipal areas(58.29%)had a higher prevalence than county areas(51.75%). Mild astigmatism was the most common(63.82%), with moderate astigmatism increasing with age. The highest prevalence of high astigmatism was observed in 11-years-old children(9.68%). Compound myopic astigmatism(59.28%)and mixed astigmatism(25.16%)were the most frequent types. With increasing age, compound myopic astigmatism increased, while simple myopic, simple hyperopic, and compound hyperopic astigmatism decreased. Mixed astigmatism increased from ages 6 to 7, but declined from ages 7 to 12. For astigmatic axis types, with-the-rule astigmatism was the most prevalent(81.06%)and increased with age, peaking at 11 years(85.74%). Against-the-rule astigmatism showed a declining trend, while oblique astigmatism remained relatively stable. Distribution differences in astigmatism types and axes by gender and region were observed. Significant differences in astigmatism severity, types, and axis types across different ages, genders, and regions were observed(all P<0.05). The overall refractive correction rate for children with astigmatism was only 40.18%.CONCLUSION: The overall prevalence of astigmatism among children aged 6-12 years in Shaanxi Province was 56.02%, with higher prevalence observed in boys and in municipal areas. Age, gender, and region significantly influenced the prevalence of astigmatism. Notably, less than half of the children with astigmatism received refractive correction, highlighting the need for increased attention from parents and relevant authorities.
4.Geographical Inference Study of Dust Samples From Four Cities in China Based on ITS2 Sequencing
Wen-Jun ZHANG ; Yao-Sen FENG ; Jia-Jin PENG ; Kai FENG ; Ye DENG ; Ke-Lai KANG ; Le WANG
Progress in Biochemistry and Biophysics 2025;52(4):970-981
ObjectiveIn the realm of forensic science, dust is a valuable type of trace evidence with immense potential for intricate investigations. With the development of DNA sequencing technologies, there is a heightened interest among researchers in unraveling the complex tapestry of microbial communities found within dust samples. Furthermore, striking disparities in the microbial community composition have been noted among dust samples from diverse geographical regions, heralding new possibilities for geographical inference based on microbial DNA analysis. The pivotal role of microbial community data from dust in geographical inference is significant, underscoring its critical importance within the field of forensic science. This study aims to delve deeply into the nuances of fungal community composition across the urban landscapes of Beijing, Fuzhou, Kunming, and Urumqi in China. It evaluates the accuracy of biogeographic inference facilitated by the internal transcribed spacer 2 (ITS2) fungal sequencing while concurrently laying a robust foundation for the operational integration of environmental DNA into geographical inference mechanisms. MethodsITS2 region of the fungal genomes was amplified using universal primers known as 5.8S-Fun/ITS4-Fun, and the resulting DNA fragments were sequenced on the Illumina MiSeq FGx platform. Non-metric multidimensional scaling analysis (NMDS) was employed to visually represent the differences between samples, while analysis of similarities (ANOSIM) and permutational multivariate analysis of variance (PERMANOVA) were utilized to statistically evaluate the dissimilarities in community composition across samples. Furthermore, using Linear Discriminant Analysis Effect Size (LEfSe) analysis to identify and filter out species that exhibit significant differences between various cities. In addition, we leveraged SourceTracker to predict the geographic origins of the dust samples. ResultsAmong the four cities of Beijing, Fuzhou, Kunming and Urumqi, Beijing has the highest species richness. The results of species annotation showed that there were significant differences in the species composition and relative abundance of fungal communities in the four cities. NMDS analysis revealed distinct clustering patterns of samples based on their biogeographic origins in multidimensional space. Samples from the same city exhibited clear clustering, while samples from different cities showed separation along the first axis. The results from ANOSIM and PERMANOVA confirmed the significant differences in fungal community composition between the four cities, with the most pronounced distinctions observed between Fuzhou and Urumqi. Notably, the biogeographic origins of all known dust samples were successfully predicted. ConclusionSignificant differences are observed in the fungal species composition and relative abundance among the cities of Beijing, Fuzhou, Kunming, and Urumqi. Employing fungal ITS2 sequencing on dust samples from these urban areas enables accurate inference of biogeographical locations. The high feasibility of utilizing fungal community data in dust for biogeographical inferences holds particular promise in the field of forensic science.
5.Efficacy and safety of ropivacaine combined with oxycodone for iliac fascia nerve block analgesia in patients undergoing hip replacement
Xinyue ZHANG ; Yapeng HE ; Xianlin ZHU ; Weiqing LIU ; Yi ZHANG ; Zhengsong WAN ; Nana YAO ; Junying MOU
China Pharmacy 2025;36(8):951-955
OBJECTIVE To investigate the efficacy and safety of ropivacaine combined with oxycodone for the analgesia of iliac fascia nerve block in patients undergoing hip replacement. METHODS Sixty-six patients who underwent hip replacement at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2023 to April 2024 were selected and randomly divided into observation group and control group, with 33 cases in each group. Before induction of anesthesia, ultrasound-guided iliac fascial nerve block was performed. Patients in the observation group were treated with 0.33% ropivacaine+0.1 mg/kg oxycodone injection mixture 30 mL, and patients in the control group were treated with 0.33% ropivacaine injection 30 mL. The time of first postoperative rescue analgesia, 24 h postoperative analgesic drug consumption, sensory block and motor block effective and maintenance time, satisfaction degree, numerical rating scale (NRS) pain score, Ramsay sedation score, muscle strength score, heart rate (HR), mean arterial pressure (MAP), oxygen saturation(SpO2), sleep score, anxiety score, and the occurrence of adverse reactions in the two groups were all recorded. RESULTS Compared with the control group, the first rescue analgesia time after operation was significantly prolonged in the observation group, and 24 h postoperative analgesic drug consumption after operation decreased; the effective time of sensory block was significantly shortened, and the maintenance time of sensory block was significantly prolonged, and the satisfaction score was higher; the NRS pain score after iliac fascia nerve block was lower, HR and MAP were lower, and the anxiety score and sleep score 24 and 48 h after operation were lower (P<0.05). In terms of safety, patients in both groups had adverse reactions after operation, such as hypertension, nausea, vomiting, and dizziness, but there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSIONS Oxycodone combined with ropivacaine shows good efficacy and safety for iliac fascial nerve block analgesia in patients undergoing hip replacement, can significantly prolong the analgesic time of ropivacaine, reduce postoperative analgesic drug consumption, improve the sleep quality of patients, and promote the rapid recovery of patients.
6.The mechanism and clinical application value of interleukin-10 family in anti-hepatic fibrosis
Qi LUO ; Biyu ZENG ; Rong ZHANG ; Liangjiang HUANG ; Lei FU ; Chun YAO
Journal of Clinical Hepatology 2025;41(4):748-754
The interleukin-10 (IL-10) family is expressed in various types of cells and has a wide range of biological functions, and it plays an important role in the development and progression of hepatic fibrosis. Hepatic fibrosis is a chronic liver disease characterized by abnormal repair of hepatic tissues after injury, activation of hepatic stellate cells, and excessive accumulation of extracellular matrix. The IL-10 family members include IL-10, IL-19, IL-20, IL-22, IL-24, IL-26, IL-28, IL-29, and IL-35, with similarities in structure and function, and changes in their expression levels are closely associated with the progression of hepatic fibrosis. Moderate upregulation of the expression of IL-10 family members can help maintain the quiescent state of hepatic stellate cells, promote the transformation of macrophages to anti-inflammatory phenotype, and regulate the activity of natural killer cells, thereby inhibiting inflammatory response, regulating cell apoptosis and autophagy, and finally reversing the progression of hepatic fibrosis. This article discusses the mechanism of action of IL-10 family members and their application in traditional Chinese medicine and Western medicine therapies, in order to provide new thoughts for the treatment of hepatic fibrosis.
7.Jiebiao Qingli Decoction Regulates TLR7/MAPK/NF-κB Pathway to Prevent and Treat Pneumonia Induced by IAV Infection
Yu MING ; Yichuan MA ; Ruiqi YAO ; Yan CHAO ; Hongchun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):173-181
ObjectiveTo explore the mechanism of Jiebiao Qingli decoction (JQD) in treating pneumonia caused by influenza A virus (IAV) infection. MethodsA total of 132 Balb/c mice were randomly assigned into normal control (NC), model control (IAV), oseltamivir (OSV, 37.5 mg·kg-1), and high-, medium-, low-dose JQD (H-, M-, and L-JQD: 6.05, 3.02, and 1.51 g·kg-1, respectively) groups. The NC group was treated with normal saline nasal drops, and the other groups were intranasally inoculated with A/Brisbane/02/2018 (H1N1) [pdm09-like virus (H1N1)] for the modeling of IAV infection. Two hours post-modeling, the NC and IAV groups were administrated with normal saline by gavage, while other groups received corresponding drugs for 7 d. The body mass, survival status, and deaths of mice were recorded daily during the administration of the drugs. On days 3 and 7, the lung index was measured for mice in each group. Pathological changes in the lung tissue were observed via hematoxylin-eosin staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was conducted to measure the viral load (IAV-M) and the mRNA levels of Toll-like receptor 7 (TLR7), p38 mitogen-activated protein kinase (p38 MAPK), and nuclear factor-kappa B (NF-κB) in the lung tissue. Western blot was employed to measure the protein levels of p38 MAPK and NF-κB. Enzyme-linked immunosorbent assay was used to quantify serum levels of interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). ResultsCompared with the NC group, the IAV group showed reduced survival quality and survival days (P<0.01), lung congestion, inflammatory cell infiltration, elevated lung index (P<0.01), increased viral load (P<0.01), upregulated TLR7, p38 MAPK, and NF-κB levels (P<0.05, P<0.01), decreased IL-2 level (P<0.01), and elevated IL-6 and TNF-α levels (P<0.01). Compared with the IAV group, H-JQD prolonged survival days (P<0.05). All JQD groups alleviated pathological changes in the lung tissue and reduced the lung index (P<0.01). M-JQD and H-JQD decreased the viral load (P<0.01). H-JQD downregulated the mRNA levels of TLR7, p38 MAPK, and NF-κB (P<0.05, P<0.01) and the protein levels of p38 MAPK and NF-κB (P<0.01), increased the serum IL-2 level (P<0.01), and lowered the IL-6 and TNF-α levels (P<0.05, P<0.01). M-JQD downregulated the mRNA level of NF-κB (P<0.01) and the protein level of p38 MAPK (P<0.05), elevated the IL-2 level (P<0.01), and lowered the TNF-α level (P<0.01). ConclusionM- and H-JQD can prevent and control IAV infection-induced pneumonia dose-dependently by inhibiting the TLR7/MAPK/NF-κB signaling pathway, increasing IL-2, and reducing excessive secretion of IL-6 and TNF-α.
8.Toxic Components, Toxicity Mechanisms, Toxicity Attenuation Measures, and Evaluation Methods of Renal Injury-inducing Chinese Medicine
Xin HUANG ; Lujin ZHANG ; Mingsan MIAO ; Can WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):295-304
ObjectiveWe reviewed the existing experimental studies about renal injury-inducing Chinese medicine and systematically analyzed the toxicity mechanisms, toxic components, toxicity attenuation measures, and modern evaluation methods of renal injury-inducing Chinese medicine. The results are expected to provide new ideas for the modern research on kidney injury-inducing Chinese medicine, offer new breakthrough points for the toxicity attenuation of Chinese medicine by compatibility and processing, and give insights into the future research of Chinese medicine toxicology on the basis of ensuring the safety and scientific application of Chinese medicine. MethodsThe animal, cell, and clinical studies of kidney injury-inducing Chinese medicine were retrieved from CNKI, Wanfang Data, VIP, PubMed, and Web of Science. The names and toxic components of renal injury-inducing Chinese medicine, renal injury sites, toxicity mechanisms, toxicity attenuation measures, and related evaluation methods were summarized. ResultsThe toxicity mechanisms of kidney injury-inducing Chinese medicine mainly involved oxidative stress, endoplasmic reticulum stress, inflammatory cell infiltration, and organic anion transporters. Processing and compatibility were the main toxicity attenuation measures. The evaluation methods encompassed animal experiments, cell models, network pharmacology, metabolomics, toxicology genomics, and fluorescent probe technology. ConclusionAt present, the toxicological verification of kidney injury-inducing Chinese medicine starts from toxic components and combines various experimental methods, which is more comprehensive and systematic than the previous studies based on only animal experiments. According to the classical theories of traditional Chinese medicine, the toxicity of kidney injury-inducing Chinese medicine is mainly attenuated by decocting in water, steaming, and frying. With the progress of science and technology, new processing methods for toxicity attenuation are emerging, and structural transformation, fermentation, and microwave methods are the key research directions of toxicity attenuation of Chinese medicine in recent years.
9.Jiebiao Qingli Decoction Regulates TLR7/MAPK/NF-κB Pathway to Prevent and Treat Pneumonia Induced by IAV Infection
Yu MING ; Yichuan MA ; Ruiqi YAO ; Yan CHAO ; Hongchun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):173-181
ObjectiveTo explore the mechanism of Jiebiao Qingli decoction (JQD) in treating pneumonia caused by influenza A virus (IAV) infection. MethodsA total of 132 Balb/c mice were randomly assigned into normal control (NC), model control (IAV), oseltamivir (OSV, 37.5 mg·kg-1), and high-, medium-, low-dose JQD (H-, M-, and L-JQD: 6.05, 3.02, and 1.51 g·kg-1, respectively) groups. The NC group was treated with normal saline nasal drops, and the other groups were intranasally inoculated with A/Brisbane/02/2018 (H1N1) [pdm09-like virus (H1N1)] for the modeling of IAV infection. Two hours post-modeling, the NC and IAV groups were administrated with normal saline by gavage, while other groups received corresponding drugs for 7 d. The body mass, survival status, and deaths of mice were recorded daily during the administration of the drugs. On days 3 and 7, the lung index was measured for mice in each group. Pathological changes in the lung tissue were observed via hematoxylin-eosin staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was conducted to measure the viral load (IAV-M) and the mRNA levels of Toll-like receptor 7 (TLR7), p38 mitogen-activated protein kinase (p38 MAPK), and nuclear factor-kappa B (NF-κB) in the lung tissue. Western blot was employed to measure the protein levels of p38 MAPK and NF-κB. Enzyme-linked immunosorbent assay was used to quantify serum levels of interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). ResultsCompared with the NC group, the IAV group showed reduced survival quality and survival days (P<0.01), lung congestion, inflammatory cell infiltration, elevated lung index (P<0.01), increased viral load (P<0.01), upregulated TLR7, p38 MAPK, and NF-κB levels (P<0.05, P<0.01), decreased IL-2 level (P<0.01), and elevated IL-6 and TNF-α levels (P<0.01). Compared with the IAV group, H-JQD prolonged survival days (P<0.05). All JQD groups alleviated pathological changes in the lung tissue and reduced the lung index (P<0.01). M-JQD and H-JQD decreased the viral load (P<0.01). H-JQD downregulated the mRNA levels of TLR7, p38 MAPK, and NF-κB (P<0.05, P<0.01) and the protein levels of p38 MAPK and NF-κB (P<0.01), increased the serum IL-2 level (P<0.01), and lowered the IL-6 and TNF-α levels (P<0.05, P<0.01). M-JQD downregulated the mRNA level of NF-κB (P<0.01) and the protein level of p38 MAPK (P<0.05), elevated the IL-2 level (P<0.01), and lowered the TNF-α level (P<0.01). ConclusionM- and H-JQD can prevent and control IAV infection-induced pneumonia dose-dependently by inhibiting the TLR7/MAPK/NF-κB signaling pathway, increasing IL-2, and reducing excessive secretion of IL-6 and TNF-α.
10.Toxic Components, Toxicity Mechanisms, Toxicity Attenuation Measures, and Evaluation Methods of Renal Injury-inducing Chinese Medicine
Xin HUANG ; Lujin ZHANG ; Mingsan MIAO ; Can WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):295-304
ObjectiveWe reviewed the existing experimental studies about renal injury-inducing Chinese medicine and systematically analyzed the toxicity mechanisms, toxic components, toxicity attenuation measures, and modern evaluation methods of renal injury-inducing Chinese medicine. The results are expected to provide new ideas for the modern research on kidney injury-inducing Chinese medicine, offer new breakthrough points for the toxicity attenuation of Chinese medicine by compatibility and processing, and give insights into the future research of Chinese medicine toxicology on the basis of ensuring the safety and scientific application of Chinese medicine. MethodsThe animal, cell, and clinical studies of kidney injury-inducing Chinese medicine were retrieved from CNKI, Wanfang Data, VIP, PubMed, and Web of Science. The names and toxic components of renal injury-inducing Chinese medicine, renal injury sites, toxicity mechanisms, toxicity attenuation measures, and related evaluation methods were summarized. ResultsThe toxicity mechanisms of kidney injury-inducing Chinese medicine mainly involved oxidative stress, endoplasmic reticulum stress, inflammatory cell infiltration, and organic anion transporters. Processing and compatibility were the main toxicity attenuation measures. The evaluation methods encompassed animal experiments, cell models, network pharmacology, metabolomics, toxicology genomics, and fluorescent probe technology. ConclusionAt present, the toxicological verification of kidney injury-inducing Chinese medicine starts from toxic components and combines various experimental methods, which is more comprehensive and systematic than the previous studies based on only animal experiments. According to the classical theories of traditional Chinese medicine, the toxicity of kidney injury-inducing Chinese medicine is mainly attenuated by decocting in water, steaming, and frying. With the progress of science and technology, new processing methods for toxicity attenuation are emerging, and structural transformation, fermentation, and microwave methods are the key research directions of toxicity attenuation of Chinese medicine in recent years.

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