1.Role of Macrophage Activation and Polarization in Diabetes Mellitus and Its Related Complications and Traditional Chinese Medicine Intervention
Zhichao CHEN ; Qiaoni LIN ; Liya SUN ; Jinxi WANG ; Zishan FU ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):311-320
The occurrence of diabetes mellitus (DM) is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver,fat,skeletal muscle,islets, and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response,improving insulin resistance,and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing,heat-clearing, and detoxicating medicinal,which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore,by summarizing the mechanisms between macrophage activation,polarization, and insulin resistance in various tissues,this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio,providing references for the future treatment of DM and its related complications with traditional Chinese medicine.
2.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
3.Advancements in herbal medicine-based nanozymes for biomedical applications.
Mei YANG ; Zhichao DENG ; Yuanyuan ZHU ; Chenxi XU ; Chenguang DING ; Yujie ZHANG ; Mingxin ZHANG ; Mingzhen ZHANG
Chinese Medical Journal 2025;138(9):1037-1049
Nanozymes are a distinct category of nanomaterials that exhibit catalytic properties resembling those of enzymes such as peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). Nanozymes derived from Chinese herbal medicines exhibit the catalytic functions of their enzyme mimics, while retaining the specific medicinal properties of the herb (termed "herbzymes"). These nanozymes can be categorized into three main groups based on their method of synthesis: herb carbon dot nanozymes, polyphenol-metal nanozymes, and herb extract nanozymes. The reported catalytic activities of herbzymes include POD, SOD, CAT, and GPx. This review presents an overview of the catalytic activities and potential applications of nanozymes, introduces the novel concept of herbzymes, provides a comprehensive review of their classification and synthesis, and discusses recent advances in their biomedical applications. Furthermore, we also discuss the significance of research into herbzymes, including the primary challenges faced and future development directions.
Nanostructures/chemistry*
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Humans
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Herbal Medicine/methods*
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Superoxide Dismutase/chemistry*
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Catalase/chemistry*
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Drugs, Chinese Herbal/chemistry*
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Catalysis
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Glutathione Peroxidase/chemistry*
4.Prognostic value of ultrasound carotid plaque length in patients with coronary artery disease.
Wendong TANG ; Zhichao XU ; Tingfang ZHU ; Yawei YANG ; Jian NA ; Wei ZHANG ; Liang CHEN ; Zongjun LIU ; Ming FAN ; Zhifu GUO ; Xianxian ZHAO ; Yuan BAI ; Bili ZHANG ; Hailing ZHANG ; Pan LI
Chinese Medical Journal 2025;138(14):1755-1757
5.Establishment of a risk prediction model for patients with type 2 diabetes and coronary heart disease based on machine learning of laboratory data
Zhichao GU ; Yunzhe WU ; Fan YANG ; Yide LU
International Journal of Laboratory Medicine 2025;46(2):135-140
Objective To analyze the characteristics of clinical indicators in patients with type 2 diabetes,and to establish a simple and effective risk prediction model for type 2 diabetes complicated with coronary heart disease by screening risk prediction indicators with machine learning.Methods A retrospective study was conducted,and 217 patients diagnosed with coronary artery disease combined with type 2 diabetes mellitus who were hospitalized in the Hospital from January 2022 to November 2023 were selected.Additionally,214 patients diagnosed with T2DM during the same period in the outpatient department were selected as the con-trol group.Their routine laboratory test data were recorded.The Least Absolute Shrinkage and Selection Op-erator(Lasso)algorithm was used to select features,and the models were built by using seven machine learn-ing algorithms:Random Forest,Decision Tree,Support Vector Machine,eXtreme Gradient Boosting,Logistic Regression,K-Nearest Neighbor,and Artificial Neural Network.The diagnostic efficacy of different models through receiver operating characteristic curve(ROC),area under curve(AUC),calibration curve,specificity,sensitivity,F1 value,and other indicators were evaluated.Results Twenty key factors,including age,gender,systolic blood pressure,diastolic blood pressure,heart rate,C-reactive protein and blood glucose were selected using Lasso regression.When incorporated into various models,the SVM model exhibited the highest sensitiv-ity(88.37%),negative predictive value(82.14%),and area under curve(0.845).The Random Forest model had the highest accuracy(76.47%),positive predictive value(76.74%),and F1 score(0.77).Meanwhile,the XGBoost algorithm demonstrated relatively good specificity(80.95%).After introducing the SHAP model,it was inferred that blood glucose had a significant positive impact on the occurrence of coronary heart disease in individuals with type 2 diabetes.Conclusion Machine learning can serve as an effective tool for assessing the risk of coronary heart disease in patients with type 2 diabetes.In this study,SVM,Random Forest,and XG-Boost models all demonstrate good predictive performance,indicating promising clinical application prospects.
6.Clinical Efficacy of Gushang External Wash Granules Combined with Extracorporeal Shockwave Therapy for Early-to-Middle-Stage Knee Osteoarthritis of Cold-Damp Obstruction Type
Jinhui YANG ; Zhaoping LU ; Zhongsen YE ; Zhichao TAN
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(8):1898-1905
Objective To evaluate the clinical efficacy of Gushang External Wash Granules combined with extracorporeal shockwave therapy(ESWT)in treating early-to-middle-stage knee osteoarthritis(KOA)with cold-damp obstruction syndrome.Methods A total of 84 patients diagnosed as early-to-middle-stage KOA(cold-damp obstruction syndrome)at the Orthopedic Outpatient Clinic of Dongguan Hospital of Guangzhou University of Chinese Medicine(Dongguan Traditional Chinese Medicine Hospital)from July 2022 to July 2023 were enrolled.Patients were randomly assigned to either the observation group or control group using a random number table,with 42 cases in each group.Both groups received ESWT,while the observation group additionally underwent topical washing with Gushang External Wash Granules.The treatment course lasted 4 weeks for both groups.The changes in traditional Chinese medicine(TCM)syndrome scores,Visual Analogue Scale(VAS)scores for pain,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores in the two groups were measured before and after treatment,and the clinical efficacy was evaluated after treatment.Results(1)After 4 weeks of treatment,the total effective rate was 95.24%(40/42)in the observation group versus 76.19%(32/42)in the control group.Intergroup comparison(tested by chi-square test)showed significantly superior efficacy in the observation group(P<0.05).(2)After treatment,both groups demonstrated significant reductions in VAS pain scores compared to those before treatment(P<0.01),while no statistically significant difference was found between groups(P>0.05).(3)WOMAC scores were decreased significantly in both groups after treatment(P<0.01),and the observation group showed significantly greater reduction than the control group(P<0.01),with statistically significance.(4)After treatment,the scores for the TCM symptoms of intolerance of cold and limb chilling,restricted flexion-extension,and stiffness and numbness in the extremities were significantly reduced in both groups(P<0.01),and the observation group demonstrated significantly greater improvements in all TCM syndrome scores than the control group(P<0.01).Conclusion The combination of Gushang External Wash Granules and ESWT demonstrates significant efficacy for the patients with early-to-middle-stage KOA of cold-damp obstruction type,and is effective on alleviating clinical symptoms and improving knee function and quality of life of the patients.
7.Application of enhanced CT,energy spectrum CT and enhanced MR in evaluating hepatocellular carcinoma after TACE treatment
Zhichao CAO ; Huanyu CHEN ; Hong ZHANG ; Qianqian YANG ; Wuhao LI ; Yaqi WANG ; Kewu HE
Journal of Interventional Radiology 2025;34(9):971-976
Objective To assess the clinical value of conventional contrast enhanced CT(CECT),multi parameter energy spectrum CT,and contrast enhanced MR(CEMR)imaging methods in evaluating hepatocellular carcinoma(HCC)after TACE treatment.Methods The clinical data of 66 HCC patients,who underwent TACE treatment at authors' hospital and received CECT,multi parameter energy spectrum CT and CEMR in 1-3 months after treatment,were retrospectively analyzed.Taking DSA results as the gold standard,the recurrent or residual lesions detected by DSA were classified as positive lesions,while the lesions having no obvious recurrence or residues were classified as negative lesions.The positive lesions that were detected by both DSA and other imaging methods were regarded as true positive lesions.The accuracy,sensitivity,specificity,Kappa value were used to compare the values of CECT,multi parameter energy spectrum CT and CEMR in evaluating the positive/negative lesions of HCC after TACE treatment,and the number of detected lesions and accuracy rate were used to evaluate the values of the above imaging methods in demonstrating the iodine oil deposition status and in diagnosing true positive lesions.Results A total of 133 positive lesions and 35 negative lesions were detected by DSA.The accuracy of CEMR in diagnosing lesions was highest,the accuracy rate was 88.70%(both P<0.05);CEMR and energy spectrum CT had the highest diagnostic efficiency,the sensitivity for positive lesions was 92.31%and 81.95%respectively,and the difference between the two methods was not statistically significant(P>0.05).No statistically significant difference in the ability of diagnosing negative lesions existed between each other among the three groups(all P>0.05).The Kappa value suggested that the ability for diagnosing lesions after TACE treatment of CEMR was stronger than that of energy spectrum CT(Kappa value was 0.68 and 0.56 respectively,both P<0.05).CECT and multi parameter energy spectrum CT had the same accuracy in evaluating the iodine oil deposition status(both were 91.7%).No statistically significant difference in diagnosing even iodine oil deposition of the true positive lesions existed between each other among the three groups(all P>0.05).For diagnosing uneven iodine oil deposition of the true positive lesions,CEMR had the highest accuracy(92.50%,all P<0.05).Conclusion CEMR and multi parameter energy spectrum CT have more reliable diagnostic performance than conventional CECT,besides,CEMR has the highest diagnostic performance.However,multi parameter energy spectrum CT and CECT are the better choice for evaluating the deposition status of iodine oil.
8.Relationship between dried fruit intake and risk of colorectal cancer:a two-sample Mendelian randomization study
Zhichao JIN ; Hong DAI ; Ran YANG
Journal of Clinical Medicine in Practice 2025;29(13):39-43,49
Objective To investigate the causal relationship between dried fruit intake and color-ectal cancer(CRC)by using a two-sample Mendelian randomization(MR)approach.Methods Two-sample MR analysis was conducted utilizing summary data from genome-wide association studies on dried fruit intake and colorectal cancer.Separate analyses were performed using data for colon cancer and rectal cancer for validation.Genetic variants significantly and independently associated with dried fruit intake were selected as instrumental variables.The inverse variance weighted method,MR-Egger regression,weighted median method,simple mode method,and weighted mode method were employed as the primary analytical approaches.Heterogeneity tests,pleiotropy analysis,and sensitivity analysis were conducted to evaluate the reliability of the study.Results A total of 21 single nucleotide poly-morphisms(SNPs)associated with dried fruit intake were included as instrumental variables.The in-verse variance weighted analysis revealed that increased dried fruit intake was associated with a reduced risk of colorectal cancer(OR=0.55,95%CI,0.32 to 0.96,P=3.53 × 10-2),with consistent results observed for both colon cancer and rectal cancer.The findings of this study were not influenced by plei-otropy or heterogeneity,and the reliability of the results was validated by sensitivity analysis.Conclu-sion Increasing dried fruit intake has potential preventive value against colorectal cancer.
9.Strategies for repairing injured anterior cruciate ligament and promoting graft healing
Chen BAI ; Wenqian YANG ; Zhichao MENG ; Yuze WANG
Chinese Journal of Tissue Engineering Research 2024;28(9):1457-1463
BACKGROUND:In recent years,the treatment of anterior cruciate ligament injury has become more and more mature.However,there are still disputes about the timing of surgery,the choice of surgical methods,the choice of grafts,and the methods to promote graft healing after anterior cruciate ligament injury. OBJECTIVE:To summarize the latest research progress of surgical timing,surgical methods,graft selection and methods to promote graft healing after anterior cruciate ligament injury,and to find new treatment directions for anterior cruciate ligament injury. METHODS:Relevant articles concerning anterior cruciate ligament injury were retrieved from PubMed,CNKI,WanFang Date,VIP,SinoMed,ScienceDirect,Springer and Cochrane Library.After the screening,72 related articles were finally included. RESULTS AND CONCLUSION:(1)Surgical timing:Compared with delayed anterior cruciate ligament reconstruction,early reconstruction can reduce meniscus injury,elevate quality of life,and improve functional recovery.However,it is still uncertain whether the different operation timing will accelerate cartilage injury.(2)Surgical methods:Arthroscopic anterior cruciate ligament reconstruction is a common surgical method for anterior cruciate ligament injury.Dynamic internal stabilization repair of anterior cruciate ligament can bring similar results to traditional anterior cruciate ligament reconstruction in short-term and long-term effects.(3)Graft selection:Autogenous hamstring tendon is the first choice of anterior cruciate ligament graft,while bone-patellar tendon-bone grafts and allografts are the secondary choices.(4)Among the methods to promote graft healing,suture band strengthening can increase knee joint stability and ensure graft healing.Stem cells promote the tendon-bone healing of grafts through anti-inflammatory action,angiogenesis,inhibition of osteolysis and promotion of chondrocyte differentiation.Preserving the residual end of the anterior cruciate ligament can maintain the stability of the knee joint,promote the recovery of proprioception,and provide a prerequisite for the healing of the graft.The effectiveness of platelet-rich plasma in promoting graft healing remains to be discussed.However,biomaterials,gene therapy,stem cell application and other methods to promote tendon healing remain in the stage of molecular and animal researches.Clinical transformation is also needed in the future.
10.Relationship between "Nutrients-intestinal Flora" and Type 2 Diabetes Mellitus Based on Theory of "Linkage between Spleen and Small Intestine"
Zhichao CHEN ; Qiaoni LIN ; Jinxi WANG ; Zishan FU ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(15):206-214
The theory of "linkage between spleen and small intestine" has been put forward by doctors as early as the Ming dynasty. In traditional Chinese medicine, the spleen and small intestine cooperate and work together physiologically, and they are also closely related and interact with each other pathologically. The spleen governs transportation and transformation, which involves the function of the small intestine in transforming water and grain. The small intestine, governing the receiving and transformation of substances, depends on the normal transportation of the spleen. At the same time, it provides guarantee for the spleen to transform Qi and generate blood as well as ascend lucidity and descend turbidity. The dysfunction of spleen in transportation is closely related to the dysfunction of small intestine. The stability of intestinal microecology necessitates the normal functioning of the spleen. When the original balance of intestinal flora is disturbed, the spleen functioning will be affected. This study explored the pathogenesis and treatment of diabetes based on the physiological functions of the spleen and small intestine and the Western medicine targets of "nutrients-intestinal flora". According to modern medicine, nutrients are essential to maintain the normal physiological activities of the human body. Proper intake of nutrients can affect the absorption and metabolism of the human body for nutrients by regulating the composition and function of intestinal flora, so as to prevent the occurrence of diabetes. The imbalance of intestinal flora which harbors rich microorganisms may lead to the disturbance of energy metabolism and the dysfunction of the immune system, eventually leading to diabetes. As a metabolic disease, diabetes is closely related to the imbalance of intestinal flora and nutrient intake. Based on the theory of "linkage between spleen and small intestine", this paper discusses the relationship between spleen and small intestine. Furthermore, this paper discusses the correlation between "spleen-small intestine" and "nutrients-intestinal flora" by reviewing the latest progress in modern medicine and clinical research, aiming to provide a theoretical basis and new ideas for the clinical prevention and treatment of type 2 diabetes mellitus.

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