1.New advances in the treatment of neonatal diabetes mellitus with sulfonylureas
Xiaoyan HU ; Jinbo XIANG ; Xiaoxia ZHU ; Zheng LI ; Tingting CAO ; Ting DING ; Ziran XU ; Jingbo LI ; Youjun YANG
China Pharmacy 2026;37(9):1236-1240
Neonatal diabetes mellitus (NDM) is a rare monogenic disorder primarily caused by insufficient insulin secretion resulting from mutations in the KCNJ11 and ABCC8 genes. Sulfonylureas, represented by glibenclamide, have become the standard therapy for this type of NDM by precisely closing the mutated ATP-sensitive potassium channels in pancreatic β cells, thereby restoring insulin secretion. Clinical studies confirm that sulfonylureas enable over 90% of patients to successfully transition from insulin to oral treatment, achieving long-term stable glycemic control and improving neurological outcomes to a certain extent. In terms of safety, severe hypoglycemia induced by sulfonylureas is relatively rare and gastrointestinal reactions are mild; moreover, sulfonylureas show good long-term tolerability, and have no adverse effects on child growth and development. In the future, by further refining the full-chain management pathway of “rapid genetic diagnosis-early intervention-specialized dosage forms-long-term follow-up”, the clinical application of sulfonylureas is expected to provide NDM patients with an optimized treatment regimen and maximize their health benefits.
2.Application and Value of Authentication Methods in the Study on Traditional Chinese Medicine Classics
Lufeng ZHENG ; Zheng GE ; Xiang LI ; Guangkun CHEN ; Fanglin HU ; Yanhong YANG ; Hongtao LI
Journal of Traditional Chinese Medicine 2026;67(4):349-354
This paper systematically reviewed the concept of authentication studies on traditional Chinese medicine (TCM) classics and the research achievements of scholars across historical and contemporary periods. We categorized the authentication studies on TCM classics into four types, including work-oriented authentication research, metho-dological studies on authentication, extended authentication research, and single-book authentication. Multiple methods were applied comprehensively, including investigating bibliographic documents of successive dynasties, analyzing the academic contents of medical books, studying the textual characteristics of medical books, examining the cited references in medical books, verifying the biographies of authors, and analyzing the interpolations and accretions in medical books, to distinguish the authenticity of TCM classics. The academic value of authenticity identification of TCM classics is concluded in three aspects,i.e. it serves as an important means to distinguish authenticity from falsehood in TCM classics, an important guarantee for inheriting the essence of TCM literature, and a key to unlocking the academic treasure trove of TCM classics and achieving inheritance-based innovation, which will lay a solid documentary foundation for constructing identification methodologies and standardized systems.
3.Notoginsenoside R1 modulates mitophagy in human cardiomyocytes viathe Pink1/Parkin pathway after hypoxia/reoxygenation
Xiaoman XIONG ; Huan WU ; Shanglin LU ; Yong WANG ; Yuhua ZHENG ; Yi XIANG ; Haiyan ZHOU ; Xingde LIU
Acta Universitatis Medicinalis Anhui 2026;61(1):53-59
ObjectiveTo investigate the mechanism by which Notoginsenoside R1 (NGR1) ameliorates hypoxia/reoxygenation (H/R)-induced injury in AC16 human cardiomyocyte cell lines through the regulation of mitophagy. MethodsCommon genes linked to hypoxia/reoxygenation injury and mitophagy were identified by intersecting data from GeneCards and MitoCarta databases. AC16 cell viability was assessed via CCK-8 assay under varying NGR1 concentrations (0, 6.25, 12.5, 25, 50, 100, 200, 300, 400, 500 μmol/L). AC16 cells were divided into the following groups: control group (Control), model group (H/R), and treatment groups (H/R + NGR1 at 100, 200 and 300 μmol/L). Mitochondrial membrane potential (ΔΨm) was measured using 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolylcarbocyanine iodide (JC-1) staining. Transcriptional levels of mitophagy-related genes (Parkin, Pink1, P62) were quantified by reverse transcription-quantitative PCR (RT-qPCR). Protein expression of mitophagy-related markers (Parkin, Pink1, P62, and LC3BⅡ) was evaluated via Western blot analysis. Mitochondrial ultrastructure was visualized by transmission electron microscopy (TEM). ResultsCompared to the control group, cell viability in the H/R group significantly decreased (P<0.01). Treatment with NGR1 at concentrations above 100 μmol/L significantly enhanced the cell viability of AC16 cells compared to the H/R group (P<0.01). H/R induced a significant decrease in mitochondrial membrane potential (P<0.01), which was restored by NGR1 treatment (P<0.01). The mRNA levels of Parkin, Pink1, and P62 in the H/R group were upregulated compared to the control group (P<0.05), while NGR1 intervention downregulated their expression (P<0.05). Protein expression levels of Parkin, Pink1, and LC3BⅡ in the H/R group significantly increased, while P62 expression decreased compared to the control group (P<0.01). In contrast, different doses of NGR1 treatment significantly reduced the expression of Parkin, Pink1, and LC3BⅡ while increasing P62 expression (P<0.05). TEM revealed that the mitochondrial structure in the H/R group was severely disrupted, with fragmented and disorganized cristae, which was alleviated by NGR1. ConclusionNGR1 ameliorates H/R-induced AC16 cell injury, and its mechanism may be associated with modulating the Pink1/Parkin pathway to suppress excessive mitophagy.
4.Association of personality and sleep quality with psychological distress of junior and senior high school stduents
Chinese Journal of School Health 2026;47(1):65-69
Objective:
To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health.
Methods:
In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress.
Results:
The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ).
Conclusions
Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.
5.Research progress on regulation of antitumor immune function of γδ T cells by active ingredients of traditional Chinese medicine
Binrui WANG ; Zheng CHANG ; Meijing QIN ; Limei ZHAO ; Juanmei MO ; Xiang LU ; Chunhua LU
China Pharmacy 2026;37(13):1773-1777
γδ T cells possess both innate and adaptive immune characteristics. Their antigen recognition is independent of major histocompatibility complex presentation, and they can directly recognize abnormal tumor metabolism, showing unique application potential in tumors with low immune infiltration. This paper systematically sorts out the biological characteristics and antitumor immune functions of γδ T cells, and mainly reviews the relevant mechanisms by which active ingredients of traditional Chinese medicine regulate γδ T cells to exert antitumor immune functions. Glycyrrhiza polysaccharide and Astragalus polysaccharide can enhance the antitumor immune function of γδ T cells by promoting the expression of various cytokines, regulating intestinal flora and alleviating immunosuppressive state. Quercetin and puerarin can strengthen γδ T cell-mediated tumor cell killing by regulating the proliferation of γδ T cells, the expression of cytotoxic effector molecules and related signaling pathways. Toosendanin can potentiate γδ T cell-induced tumor cell killing by down-regulating the expression of anti-apoptotic protein in tumor cells. Artesunate can boost γδ T cell-mediated antitumor immune responses by enhancing the effector function of γδ T cells and weakening tumor immune escape. Future research shall focus on exploring the synergistic effects and molecular mechanisms of the combined application of active ingredients of traditional Chinese medicine and γδ T cell immunotherapy, and identifying the key targets for γδ T cells to exert antitumor immune functions.
6.Research progress on regulation of antitumor immune function of γδ T cells by active ingredients of traditional Chinese medicine
Binrui WANG ; Zheng CHANG ; Meijing QIN ; Limei ZHAO ; Juanmei MO ; Xiang LU ; Chunhua LU
China Pharmacy 2026;37(13):1773-1777
γδ T cells possess both innate and adaptive immune characteristics. Their antigen recognition is independent of major histocompatibility complex presentation, and they can directly recognize abnormal tumor metabolism, showing unique application potential in tumors with low immune infiltration. This paper systematically sorts out the biological characteristics and antitumor immune functions of γδ T cells, and mainly reviews the relevant mechanisms by which active ingredients of traditional Chinese medicine regulate γδ T cells to exert antitumor immune functions. Glycyrrhiza polysaccharide and Astragalus polysaccharide can enhance the antitumor immune function of γδ T cells by promoting the expression of various cytokines, regulating intestinal flora and alleviating immunosuppressive state. Quercetin and puerarin can strengthen γδ T cell-mediated tumor cell killing by regulating the proliferation of γδ T cells, the expression of cytotoxic effector molecules and related signaling pathways. Toosendanin can potentiate γδ T cell-induced tumor cell killing by down-regulating the expression of anti-apoptotic protein in tumor cells. Artesunate can boost γδ T cell-mediated antitumor immune responses by enhancing the effector function of γδ T cells and weakening tumor immune escape. Future research shall focus on exploring the synergistic effects and molecular mechanisms of the combined application of active ingredients of traditional Chinese medicine and γδ T cell immunotherapy, and identifying the key targets for γδ T cells to exert antitumor immune functions.
7.Luoshi Neiyi Prescription Treats Endometriosis Through TLR4/NF-κB Signaling Pathway
Yuanyuan RUAN ; Sai XU ; Jiangyue TANG ; Xiang LI ; You ZOU ; Fangli PEI ; Lizheng WU ; Kaidi ZHENG ; Shuhong LIN ; Weilan ZHONG ; Cheng ZENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):185-196
ObjectiveTo investigate the mechanism by which Luoshi Neiyi prescription treats endometriosis (EMs) through the Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway. MethodsAnimal experiments were conducted with 50 female SD rats, which were randomized into a sham operation group (10 rats) and a modeling group (40 rats). An autologous endometrial transplantation method was used for the modeling of EMs. The 36 successfully modeled rats were randomly allocated into four groups (n=9 each): The model group, the low-dose (7.87 g·kg-1) Luoshi Neiyi prescription group, the high-dose (15.74 g·kg-1) Luoshi Neiyi prescription group, and the dienogest (0.20 mg·kg-1) group. The physiological status and ectopic lesion volumes of rats in each group were observed. Hematoxylin-eosin (HE) staining was used to observe the morphology of the eutopic endometrial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of inflammatory factors including interleukin-1β (IL-1β) and prostaglandin E2 (PGE2) in the serum of EMs rats. Immunohistochemistry was used to detect the expression of matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor A (VEGFA) in the eutopic endometrial tissue. Western blot was adopted to determine the protein levels of TLR4, myeloid differentiation factor 88 (MyD88), phosphorylated nuclear factor-κB (p-NF-κB)/NF-κB, MMP-9, and VEGFA in the eutopic endometrial tissue. In the cell experiments, the cell-counting kit-8 (CCK-8) assay was employed to screen the optimal concentration of Luoshi Neiyi prescription-containing serum, and a scratch assay was performed to assess the migration ability of iheESCs cells. Interventions with Luoshi Neiyi prescription-containing serum, resatorvid (TAK-242, a TLR4 inhibitor), and lipopolysaccharides (LPS, a TLR4 agonist) were conducted, and Western blot was used to detect the expression of proteins related to the TLR4/NF-κB signaling pathway. ResultsThis experiment successfully replicated 36 EMs rat models. Compared with the sham operation group, the model group exhibited visible ectopic lesions on the abdominal wall and an increase in the writhing response score (P<0.01). Furthermore, HE staining revealed the model group exhibited a thickened eutopic epithelium, stromal cell disarrangement, and evident infiltration of inflammatory cells. In addition, the model group showed elevated serum levels of IL-1β and PGE2 (P<0.05, P<0.01), increased positive expression of MMP-9 and VEGFA in the ectopic endometrial tissue (P<0.01), and up-regulated protein levels of TLR4, MyD88, p-NF-κB/NF-κB, MMP-9, and VEGFA in the ectopic endometrial tissue (P<0.05, P<0.01). Compared with the model group, all treatment groups exhibited a reduction in the ectopic lesion volume (P<0.01). Furthermore, the writhing response scores were decreased in the high-dose Luoshi Neiyi prescription group and the dienogest group (P<0.05, P<0.01). The pathological state of the ectopic endometrial tissue was alleviated to varying degrees in the treatment groups. Low-dose Luoshi Neiyi prescription reduced serum PGE2 levels, and high-dose Luoshi Neiyi prescription and dienogest decreased serum IL-1β and PGE2 levels in EMs rats (P<0.05, P<0.01). The treatment groups showed decreased positive expression of MMP-9 and VEGFA in the ectopic endometrial tissue (P<0.05, P<0.01) and down-regulated protein levels of TLR4, MyD88, p-NF-κB/NF-κB, MMP-9, and VEGFA in the ectopic endometrial tissue (P<0.05, P<0.01). The cell experiments showed that 5%, 10%, and 20% Luoshi Neiyi prescription-containing sera significantly reduced the viability and inhibited the migration of iheESCs. Compared with the control group, 5%, 10%, and 20% Luoshi Neiyi prescription-containing serum groups and the TAK-242 group showed reduced protein levels of TLR4, MyD88, p-NF-κB/NF-κB, MMP-9, and VEGFA (P<0.01). Compared with the control group, the LPS group showed increased expression of the above proteins (P<0.01). Compared with the LPS group, the LPS+5%, 10%, and 20% Luoshi Neiyi prescription-containing serum groups showed reduced expression of the above proteins (P<0.05, P<0.01). ConclusionLuoshi Neiyi prescription may modulate the TLR4/NF-κB signaling pathway to reduce the inflammatory response and histopathological damage in the eutopic endometrium and suppress the adhesive, invasive, and angiogenic biological processes in the ectopic endometrial tissue, thereby exerting its therapeutic effect on EMs.
8.Mechanisms of Babaodan in Attenuating Acetaminophen-induced Acute Liver Injury via Metabolic Reprogramming and Inflammatory Pathways
Ying ZHANG ; Yuchang AN ; Xiang ZHU ; Mei ZHONG ; Yanfang ZHENG ; Mingqing HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):122-130
ObjectiveTo investigate the effects and potential mechanisms of Babaodan (BBD) against acetaminophen (APAP)-induced acute liver injury (ALI) based on transcriptomics. MethodsA total of 36 male C57BL/6 mice were randomly divided into 6 groups (n=6 per group): normal group, model group, N-acetylcysteine group (NAC, 120 mg·kg-1), and BBD low-, medium-, and high-dose groups (BBD-L, BBD-M, BBD-H groups, 75, 150, 300 mg·kg-1, respectively). Except for the normal group, all other groups were subjected to APAP-induced ALI. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were measured in each group. Hepatic levels or activities of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) were detected using commercial kits. Hematoxylin-eosin (HE) staining was performed to evaluate the degree of liver histopathological damage. Transcriptomic analysis was employed to screen differentially expressed genes (DEGs), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed to identify differential pathways involved in BBD intervention against ALI. Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot were applied to validate the expression of differential genes and related pathway proteins. Additionally, glucose (GLU) consumption, as well as lactate (LD) and adenosine triphosphate (ATP) content were assessed across all mouse groups. ResultsPharmacodynamic evaluation showed that, compared with the normal group, the model group exhibited significantly elevated serum levels of ALT, AST, TC, TG, and LDL-C (P<0.01), significantly increased MDA level (P<0.01), and significantly decreased GSH-Px level (P<0.05). Compared with the model group, BBD intervention at different doses significantly reduced the serum levels of ALT, AST, TC, TG, and LDL-C (P<0.05, P<0.01), increased GSH-Px level (P<0.05, P<0.01), significantly decreased MDA level (P<0.01), and ameliorated hepatic histopathological injury. Liver transcriptomic analysis revealed that, following high-dose BBD intervention, the core genes were mainly enriched in pathways related to inflammatory responses and energy metabolic reprogramming, including the interleukin-17 (IL-17) signaling pathway, the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, fructose and mannose metabolism, and glycolysis. Real-time PCR validation demonstrated that, compared with the normal group, the mRNA expression levels of glycolysis-related genes [hexokinase 1 (HK1), hexokinase 2 (HK2), 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3), 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 4 (PFKFB4), pyruvate kinase M (PKM), and lactate dehydrogenase A (LDHA)], as well as inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β)] were significantly upregulated in the model group (P<0.05, P<0.01). Compared with the model group, the BBD-H group showed significantly decreased mRNA expression of HK1, HK2, PFKFB3, PFKFB4, PKM, LDHA, TNF-α, IL-6, and IL-1β (P<0.05, P<0.01). Western blot results indicated that, compared with the normal group, the model group had significantly increased expression of glycolysis-related proteins [glucose transporter 1 (GLUT1), HK1, PFKFB3, and PKM], inflammatory proteins [interleukin-18 (IL-18), TNF-α, and IL-1β], and phosphorylated (p)-PI3K and p-Akt proteins (P<0.05, P<0.01). Compared with the model group, the BBD-H group exhibited significantly decreased expression of GLUT1, HK1, PFKFB3, PKM, IL-18, TNF-α, IL-1β, p-PI3K, and p-Akt (P<0.05, P<0.01). Metabolic indicator measurements showed that, compared with the model group, the BBD-H group showed significantly reduced GLU consumption, LD and ATP content (P<0.05, P<0.01). ConclusionBBD may alleviate APAP-induced ALI through dual regulation of metabolic reprogramming and inflammatory responses, potentially via inhibition of the PI3K/Akt signaling pathway.
9.Mechanisms of Babaodan in Attenuating Acetaminophen-induced Acute Liver Injury via Metabolic Reprogramming and Inflammatory Pathways
Ying ZHANG ; Yuchang AN ; Xiang ZHU ; Mei ZHONG ; Yanfang ZHENG ; Mingqing HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):122-130
ObjectiveTo investigate the effects and potential mechanisms of Babaodan (BBD) against acetaminophen (APAP)-induced acute liver injury (ALI) based on transcriptomics. MethodsA total of 36 male C57BL/6 mice were randomly divided into 6 groups (n=6 per group): normal group, model group, N-acetylcysteine group (NAC, 120 mg·kg-1), and BBD low-, medium-, and high-dose groups (BBD-L, BBD-M, BBD-H groups, 75, 150, 300 mg·kg-1, respectively). Except for the normal group, all other groups were subjected to APAP-induced ALI. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were measured in each group. Hepatic levels or activities of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) were detected using commercial kits. Hematoxylin-eosin (HE) staining was performed to evaluate the degree of liver histopathological damage. Transcriptomic analysis was employed to screen differentially expressed genes (DEGs), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed to identify differential pathways involved in BBD intervention against ALI. Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot were applied to validate the expression of differential genes and related pathway proteins. Additionally, glucose (GLU) consumption, as well as lactate (LD) and adenosine triphosphate (ATP) content were assessed across all mouse groups. ResultsPharmacodynamic evaluation showed that, compared with the normal group, the model group exhibited significantly elevated serum levels of ALT, AST, TC, TG, and LDL-C (P<0.01), significantly increased MDA level (P<0.01), and significantly decreased GSH-Px level (P<0.05). Compared with the model group, BBD intervention at different doses significantly reduced the serum levels of ALT, AST, TC, TG, and LDL-C (P<0.05, P<0.01), increased GSH-Px level (P<0.05, P<0.01), significantly decreased MDA level (P<0.01), and ameliorated hepatic histopathological injury. Liver transcriptomic analysis revealed that, following high-dose BBD intervention, the core genes were mainly enriched in pathways related to inflammatory responses and energy metabolic reprogramming, including the interleukin-17 (IL-17) signaling pathway, the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, fructose and mannose metabolism, and glycolysis. Real-time PCR validation demonstrated that, compared with the normal group, the mRNA expression levels of glycolysis-related genes [hexokinase 1 (HK1), hexokinase 2 (HK2), 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3), 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 4 (PFKFB4), pyruvate kinase M (PKM), and lactate dehydrogenase A (LDHA)], as well as inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β)] were significantly upregulated in the model group (P<0.05, P<0.01). Compared with the model group, the BBD-H group showed significantly decreased mRNA expression of HK1, HK2, PFKFB3, PFKFB4, PKM, LDHA, TNF-α, IL-6, and IL-1β (P<0.05, P<0.01). Western blot results indicated that, compared with the normal group, the model group had significantly increased expression of glycolysis-related proteins [glucose transporter 1 (GLUT1), HK1, PFKFB3, and PKM], inflammatory proteins [interleukin-18 (IL-18), TNF-α, and IL-1β], and phosphorylated (p)-PI3K and p-Akt proteins (P<0.05, P<0.01). Compared with the model group, the BBD-H group exhibited significantly decreased expression of GLUT1, HK1, PFKFB3, PKM, IL-18, TNF-α, IL-1β, p-PI3K, and p-Akt (P<0.05, P<0.01). Metabolic indicator measurements showed that, compared with the model group, the BBD-H group showed significantly reduced GLU consumption, LD and ATP content (P<0.05, P<0.01). ConclusionBBD may alleviate APAP-induced ALI through dual regulation of metabolic reprogramming and inflammatory responses, potentially via inhibition of the PI3K/Akt signaling pathway.
10.Imported familial clustering of clonorchiasis in Shanghai Municipality: a report of three cases
Yawen HAN ; Yuchao ZHENG ; Yuejuan ZHANG ; Lunhui XIANG ; Wenda CHU
Chinese Journal of Schistosomiasis Control 2026;38(4):450-454
This article presented the diagnosis and treatment of three patients from the first imported familial clustering of clonorchiasis in Shanghai Municipality, and evaluated the value of different stool examination methods in non-endemic areas of clonorchiasis. In February 2026, the first case of clonorchiasis in this family was confirmed, and subsequent epidemiological surveys revealed that four family members all had a history of traveling to Guangdong Province and consuming raw freshwater fish. Stool samples were collected from all four individuals and detected for Clonorchis sinensis eggs using both machine smear method and the modified Kato-Katz thick smear method. C. sinensis infection was detected among three individuals using the Kato-Katz method, with severe [20 448 eggs per gram (EPG)], moderate (2 376 EPG), and mild infections (960 EPG) identified, respectively, and no C. sinensis eggs were identified in the remaining one stool sample. In contrast, only one infection was detected with the machine smear method, resulting in a underdiagnosis rate of 66.67% (2/3). All three confirmed cases were cured following standardized therapy. This article indicates that imported familial clustering clonorchiasis cases are highly occult in non-endemic areas, and the machine smear method has a high risk of underdiagnosis during initial screening. A two-tier diagnostic model combining “machine smear method for initial screening + Kato-Katz method for confirmation” is recommended.


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