1.Study on the Regional Distribution Characteristics of TCM Syndrome of 6 447 Elderly Patients with Coronary Heart Disease Based on Literature
Yueying ZHANG ; Zhongwen QI ; Jiaqi HUI ; Tong LI ; Wenxin ZOU ; Fengqin XU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):66-73
Objective To analyze the geographical distribution characteristics of TCM syndromes of coronary heart disease in the elderly based on the literature;To summarize the characteristics of TCM syndromes of coronary heart disease patients in different geographical areas;To provide evidence-based data for the standardization of TCM syndromes and syndrome differentiation treatment of coronary heart disease in the elderly.Methods Literature on TCM syndrome of coronary heart disease in the elderly was retrieved from CNKI,Wanfang Data,VIP,CBM and PubMed,from the establishment of each database to December 31,2024.The common TCM syndrome types,syndrome frequency and regional distribution of coronary heart disease in the elderly were statistically analyzed.Results Forty articles were included,with a total number of 6 447 cases and a male-to-female ratio of 1.1∶1.The top 5 highest percentage of co-morbidities of coronary artery disease in the elderly were 1 308 cases of hypertension(24.11%),1 022 cases of type 2 diabetes mellitus(18.84%),787 cases of respiratory disease(14.51%),517 cases of heart failure(9.53%),and 348 cases of hyperlipidemia(6.41%).The top 5 TCM syndromes in elderly patients with coronary heart disease included 779 cases of qi deficiency and blood stasis(12.08%),692 cases of qi-yin deficiency(10.73%),367 cases of phlegm-blood stasis(5.69%),363 cases of heart blood stagnant blockade(5.63%),and 343 cases of qi stagnation and blood stasis(5.32%).The distribution of TCM syndromes in different regions was characterized by qi deficiency,blood stasis and phlegm stasis in the northeast;qi deficiency,blood stasis and qi yin deficiency in the north;qi deficiency,blood stasis and phlegm internal obstruction in the east;qi and yin deficiency and heart blood stasis in the central;qi deficiency,blood stasis and phlegm stasis in the south;phlegm and yin paralysis obstruction,qi and yin deficiency in the southwest;stasis blockage of the cardiac veins,qi yin deficiency in the northwest.The overall trend was that the number of syndromes in the north was higher than that in the south;the number of syndromes in the east,centre and west was decreasing.The distribution of yin deficiency syndrome was highest in the southwest(23.33%)and lowest in the east(10.93%);yang deficiency syndrome was highest in the southwest(13.30%)and lowest in the central(3.32%);qi deficiency and blood stasis syndrome was highest in the northeast(32.89%)and lowest in the northwest(7.24%);the distribution of qi-yin deficiency was highest in the southwest(23.33%)and lowest in the east(7.22%);the distribution of phlegm and stasis syndrome was highest in the northeast(25.67%)and lowest in the east(1.69%).The overall generalization was that deficiency,stasis and phlegm were the main syndrome factors.Conclusion The main symptoms of coronary heart disease in the elderly manifest as a mixture of deficiency and excess,qi deficiency and blood stasis syndrome is the most syndrome type of coronary heart disease in the elderly and is mainly distributed in the northeast.The distribution of TCM syndromes has regional characteristics.
2.Mendelian randomization analysis of causal association between schizophrenia and lung cancer
Kangming HUO ; Minghu CUI ; Zhongwen ZHANG
Chinese Mental Health Journal 2025;39(10):868-874
Objective:To evaluate the association between schizophrenia and risk of lung cancer using Mende-lian randomization approach.Methods:Select instrumental variables from the genome-wide association study of the Psychiatric Genomics Consortium and the UK Biobank.Two-sample Mendelian randomization of the selected in-strumental variables was performed using the inverse variance weighted method as the primary method of analysis,with the weighted median method and the MR Egger method as complementary methods of analysis.Cochran Q test was applied to analyze the heterogeneity,and MR-Egger intercept analysis and leave-one-out method were applied for pleiotropy test to assess the reliability of the analysis results.Results:For the data on schizophrenia and lung cancer,the inverse variance weighted method assessed that the risk(OR)of lung cancer in patients with schizophre-nia was 1.001 times(95%CI:1.000-1.002,P<0.01)higher than that of the general population.Both the weighted median method and the MR Egger method of assessments also indicated an increased risk of lung cancer in individuals with schizophrenia.Conclusion:Our findings suggest a potential causal association between schizo-phrenia and lung cancer.
3.Mechanism of Traditional Chinese Medicine Against Gouty Arthritis via Regulating Nrf2 Signaling Pathway: A Review
Siyi CHEN ; Shumin HUANG ; Yushan ZHAO ; Jiajin LIN ; Qian SHI ; Yefeng CHEN ; Yize ZHANG ; Zhongwen ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):323-330
Gouty arthritis (GA) is an inflammatory disorder caused by monosodium urate (MSU) crystal deposition, accompanied by elevated oxidative stress and aberrant release of inflammatory cytokines, resulting in joint tissue damage and intense pain. Nuclear factor E2-related factor 2 (Nrf2), a key transcription factor regulating the antioxidant defence system, exerts cytoprotective effects through dissociation from Kelch-like ECH-associated protein 1 (Keap1) and activates downstream antioxidant response element (ARE)-mediated pathways. It can upregulate the expression of heme oxygenase-1 (HO-1), NADH quinone oxidoreductase 1 (NQO1), superoxide dismutase (SOD), and glutathione transferase (GST) to preserve redox homeostasis. Moreover, Nrf2 can suppress activation of NOD-like receptor protein 3 (NLRP3) inflammasomes, reduce pro-inflammatory cytokine production and release, modulate nuclear factor-κB (NF-κB) transcriptional activity, regulate gut microbiota balance, enhance mitophagy, and inhibit apoptosis, so as to reduce joint inflammation and pain and promote body recovery. This review systematically examined recent advancements in traditional Chinese medicine (TCM) for GA prevention and treatment via regulating the Nrf2 signaling pathway. It delineated Nrf2's molecular mechanisms and its role in GA pathogenesis and elucidated how TCM intervenes in multiple pathways including Keap1/Nrf2/ARE, Nrf2/HO-1(NQO1), and Nrf2/NF-κB/NLRP3 to exert therapeutic effects. The study demonstrated that TCM monomers and compounds effectively counteract oxidative damage, attenuate inflammatory responses, promote autophagy, and inhibit apoptosis via regulating the Nrf2 signaling pathway. These findings not only clarify the scientific basis of TCM in GA treatment but also offer strategic insights for developing novel Nrf2-targeted anti-gout drugs.
4.Oral Herombopag Olamine and subcutaneous recombinant human thrombopoietin after haploidentical hematopoietic stem cell transplantation
Dai KONG ; Xinkai WANG ; Wenhui ZHANG ; Xiaohang PEI ; Cheng LIAN ; Xiaona NIU ; Honggang GUO ; Junwei NIU ; Zunmin ZHU ; Zhongwen LIU
Chinese Journal of Tissue Engineering Research 2025;29(1):1-7
BACKGROUND:Allogeneic hematopoietic stem cell transplantation is an important treatment for malignant hematological diseases,and delayed postoperative platelet implantation is a common complication that seriously affects the quality of patient survival;however,there are no standard protocols to improve platelet implantation rates and prevent platelet implantation delays. OBJECTIVE:To compare the safety and efficacy of oral Herombopag Olamine versus subcutaneous recombinant human thrombopoietin for promoting platelet implantation in patients with malignant hematological diseases undergoing haploid hematopoietic stem cell transplantation. METHODS:Clinical data of 163 patients with malignant hematological diseases who underwent haploidentical hematopoietic stem cell transplantation from January 2016 to October 2022 were retrospectively analyzed.A total of 72 patients who started to subcutaneously inject recombinant human thrombopoietin at+2 days were categorized into the recombinant human thrombopoietin group;a total of 27 patients who started to orally take Herombopag Olamine at+2 days were categorized into the Herombopag Olamine group;and 64 patients who did not apply Herombopag Olamine or recombinant human thrombopoietin were categorized into the blank control group.The implantation status,incidence of acute graft-versus-host disease of degree II-IV within 100 days,1-year survival rate,1-year recurrence rate,and safety were analyzed in the three groups. RESULTS AND CONCLUSION:(1)The average follow-up time was 52(12-87)months.The implantation time of neutrophils in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group was(12.95±3.88)days,(14.04±3.71)days,and(13.89±2.74)days,respectively,with no statistically significant difference(P=0.352);the implantation time of platelets was(15.16±6.27)days,(17.67±6.52)days,and(17.00±4.75)days,with no statistically significant difference(P=0.287).(2)The complete platelet implantation rate on day 60 was 64.06%,90.28%,and 92.59%,respectively,and the difference was statistically significant(P<0.001).The subgroup analysis showed that the difference between the blank control group and the recombinant human thrombopoietin group was statistically significant(P<0.001),and the difference between the blank control group and the Herombopag Olamine group was statistically significant(P=0.004).The difference was not statistically significant between the recombinant human thrombopoietin group and Herombopag Olamine group(P=0.535).(3)100-day II-IV degree acute graft-versus-host disease incidence in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group were 25.00%,30.56%,and 25.93%,respectively,and the difference was not statistically significant(P=0.752).(4)The incidence of cytomegalovirus anemia,cytomegalovirus pneumonia,and hepatic function injury had no statistical difference among the three groups(P>0.05).(5)During the follow-up period,there was no thrombotic event in any of the three groups of patients.(6)The results showed that recombinant human thrombopoietin and Herombopag Olamine could improve the platelet implantation rate of malignant hematological disease patients after haploidentical hematopoietic stem cell transplantation,with comparable efficacy and good safety.
5.Study on the clinical features and medication analysis of the elderly cognitive impairment population based on real-world data
Yueying ZHANG ; Zhongwen QI ; Tong LI ; Jiaqi HUI ; Wenxin ZOU ; Fengqin XU
International Journal of Traditional Chinese Medicine 2025;47(12):1744-1751
Objective:To conduct a multi-center cross-sectional study of elderly patients with cognitive impairment based on real-world data; To analyze the clinical characteristics and core medication law of the disease population.Methods:The medical records of elderly patients diagnosed with cognitive impairment from January 1, 2016 to December 31, 2024 were retrieved from Chinese Evidence-based TCM Database. Excel 2010 software was used to collect general information, TCM syndrome elements and syndrome types, use frequency of Chinese materia medica, property, taste, meridian tropism, efficacy classification and other information, using PivotTable to establish Chinese materia medica matrix. IBM SPSS Modeler 18.0 software was used to display the frequency of co-occurrence among high-frequency Chinese materia medica, and the association rules were analyzed based on the Apriori algorithm. R language 4.4.1 was used for clustering analysis on Chinese materia medica and the cluster pedigree and correlation heat map were drawn.Results:A total of 1 194 elderly patients with cognitive impairment were enrolled, with a mean age of (79.51±7.65) years, and the highest frequency of comorbidities was hypertension (891 cases, 74.62%); AD was the most frequent diagnosis of cognitive impairment (367 times, 30.74%). The proportion of mild cognitive impairment in the low value group of Systemic Immune Inflammation Index (SII) was relatively high, and the high value group of SII was mainly vascular dementia and AD. Wind-phlegm blocking syndrome (106 times, 13.73%) topped the list; phlegm was the most frequent element of pathogenicity (353 times, 45.73%), and meridians and collaterals (194 times, 25.13%). Totally 328 prescriptions were included, involving 308 kinds of Chinese materia medica. The total recorded frequency of Chinese materia medica was 5 665, with tonifying herbs constituting the most frequently used category, accounting for 1 633 times; the medicinal property of drugs for treating elderly patients with cognitive disorders was mostly warm (103 times, 33.44%), the taste was mostly bitter (141 times, 45.78%), and attributed to the liver meridian (145 times, 47.08%); among the two and three association rules, the drug pairs with the highest confidence were Gastrodiae Rhizoma→Uncariae Ramulus cum Uncis (97.22%) and Hyperici Perforati Herba→Acanthopanacis Senticosi Radix et Rhizoma seu Caulis+Alpiniae Oxyphyllae Fructus (97.06%); five medicinal combinations were obtained by high frequency drug clustering analysis.Conclusions:Elderly patients with cognitive impairment are mainly diagnosed with AD. There may be a potential correlation between SII level and the progression of cognitive impairment. The drugs are used to tonify the kidney and replenish essence, detoxify and unblock collaterals, replenish qi and activate blood circulation, and awaken the brain and open the orifices. Shengmai Decoction, Renshen Yangrong Decoction and other TCM classic prescriptions can be used in clinic.
6.Statistical methods for extremely unbalanced data in genome-wide association study (2)
Ning XIE ; Wenjian BI ; Zhongwen ZHANG ; Fang SHAO ; Yongyue WEI ; Yang ZHAO ; Ruyang ZHANG ; Feng CHEN
Chinese Journal of Epidemiology 2025;46(1):147-153
Extremely unbalanced data refers to datasets with independent or dependent variables showing severe imbalances in proportions, which might lead to deviation of classical test statistics from theoretical distribution and difficulties in controlling type Ⅰ error. The increased availability of genome-wide resources from large population cohorts has highlighted the growing demand for efficient and accurate statistical methods for the process of extremely unbalanced data to improve the development of genetic statistical methods. This paper introduces two widely used correction methods in current genome-wide association study for extremely unbalanced data, i.e. Firth correction and saddle point approximation, describes their effectiveness in controlling type Ⅰ errors confirmed by simulation experiments, finally, and summarizes the commonly used software for extremely unbalanced genomic data to provide theoretical reference and suggestion for its application for the statistical analysis on extremely unbalanced data in future.
7.Statistical methods for extremely unbalanced data in genome-wide association study (2)
Ning XIE ; Wenjian BI ; Zhongwen ZHANG ; Fang SHAO ; Yongyue WEI ; Yang ZHAO ; Ruyang ZHANG ; Feng CHEN
Chinese Journal of Epidemiology 2025;46(1):147-153
Extremely unbalanced data refers to datasets with independent or dependent variables showing severe imbalances in proportions, which might lead to deviation of classical test statistics from theoretical distribution and difficulties in controlling type Ⅰ error. The increased availability of genome-wide resources from large population cohorts has highlighted the growing demand for efficient and accurate statistical methods for the process of extremely unbalanced data to improve the development of genetic statistical methods. This paper introduces two widely used correction methods in current genome-wide association study for extremely unbalanced data, i.e. Firth correction and saddle point approximation, describes their effectiveness in controlling type Ⅰ errors confirmed by simulation experiments, finally, and summarizes the commonly used software for extremely unbalanced genomic data to provide theoretical reference and suggestion for its application for the statistical analysis on extremely unbalanced data in future.
8.Mendelian randomization analysis of causal association between schizophrenia and lung cancer
Kangming HUO ; Minghu CUI ; Zhongwen ZHANG
Chinese Mental Health Journal 2025;39(10):868-874
Objective:To evaluate the association between schizophrenia and risk of lung cancer using Mende-lian randomization approach.Methods:Select instrumental variables from the genome-wide association study of the Psychiatric Genomics Consortium and the UK Biobank.Two-sample Mendelian randomization of the selected in-strumental variables was performed using the inverse variance weighted method as the primary method of analysis,with the weighted median method and the MR Egger method as complementary methods of analysis.Cochran Q test was applied to analyze the heterogeneity,and MR-Egger intercept analysis and leave-one-out method were applied for pleiotropy test to assess the reliability of the analysis results.Results:For the data on schizophrenia and lung cancer,the inverse variance weighted method assessed that the risk(OR)of lung cancer in patients with schizophre-nia was 1.001 times(95%CI:1.000-1.002,P<0.01)higher than that of the general population.Both the weighted median method and the MR Egger method of assessments also indicated an increased risk of lung cancer in individuals with schizophrenia.Conclusion:Our findings suggest a potential causal association between schizo-phrenia and lung cancer.
9.Study on the Regional Distribution Characteristics of TCM Syndrome of 6 447 Elderly Patients with Coronary Heart Disease Based on Literature
Yueying ZHANG ; Zhongwen QI ; Jiaqi HUI ; Tong LI ; Wenxin ZOU ; Fengqin XU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):66-73
Objective To analyze the geographical distribution characteristics of TCM syndromes of coronary heart disease in the elderly based on the literature;To summarize the characteristics of TCM syndromes of coronary heart disease patients in different geographical areas;To provide evidence-based data for the standardization of TCM syndromes and syndrome differentiation treatment of coronary heart disease in the elderly.Methods Literature on TCM syndrome of coronary heart disease in the elderly was retrieved from CNKI,Wanfang Data,VIP,CBM and PubMed,from the establishment of each database to December 31,2024.The common TCM syndrome types,syndrome frequency and regional distribution of coronary heart disease in the elderly were statistically analyzed.Results Forty articles were included,with a total number of 6 447 cases and a male-to-female ratio of 1.1∶1.The top 5 highest percentage of co-morbidities of coronary artery disease in the elderly were 1 308 cases of hypertension(24.11%),1 022 cases of type 2 diabetes mellitus(18.84%),787 cases of respiratory disease(14.51%),517 cases of heart failure(9.53%),and 348 cases of hyperlipidemia(6.41%).The top 5 TCM syndromes in elderly patients with coronary heart disease included 779 cases of qi deficiency and blood stasis(12.08%),692 cases of qi-yin deficiency(10.73%),367 cases of phlegm-blood stasis(5.69%),363 cases of heart blood stagnant blockade(5.63%),and 343 cases of qi stagnation and blood stasis(5.32%).The distribution of TCM syndromes in different regions was characterized by qi deficiency,blood stasis and phlegm stasis in the northeast;qi deficiency,blood stasis and qi yin deficiency in the north;qi deficiency,blood stasis and phlegm internal obstruction in the east;qi and yin deficiency and heart blood stasis in the central;qi deficiency,blood stasis and phlegm stasis in the south;phlegm and yin paralysis obstruction,qi and yin deficiency in the southwest;stasis blockage of the cardiac veins,qi yin deficiency in the northwest.The overall trend was that the number of syndromes in the north was higher than that in the south;the number of syndromes in the east,centre and west was decreasing.The distribution of yin deficiency syndrome was highest in the southwest(23.33%)and lowest in the east(10.93%);yang deficiency syndrome was highest in the southwest(13.30%)and lowest in the central(3.32%);qi deficiency and blood stasis syndrome was highest in the northeast(32.89%)and lowest in the northwest(7.24%);the distribution of qi-yin deficiency was highest in the southwest(23.33%)and lowest in the east(7.22%);the distribution of phlegm and stasis syndrome was highest in the northeast(25.67%)and lowest in the east(1.69%).The overall generalization was that deficiency,stasis and phlegm were the main syndrome factors.Conclusion The main symptoms of coronary heart disease in the elderly manifest as a mixture of deficiency and excess,qi deficiency and blood stasis syndrome is the most syndrome type of coronary heart disease in the elderly and is mainly distributed in the northeast.The distribution of TCM syndromes has regional characteristics.
10.Statistical methods for extremely unbalanced data in genome-wide association study (1)
Ning XIE ; Wenjian BI ; Zhongwen ZHANG ; Fang SHAO ; Yongyue WEI ; Yang ZHAO ; Ruyang ZHANG ; Feng CHEN
Chinese Journal of Epidemiology 2024;45(11):1582-1589
Extremely unbalanced data here refers to datasets where the values of independent or dependent variables exhibit severe unbalance in proportions, such as extremely unbalanced case-control ratio, very low incidence rate of disease, heavily censored time-to-event data, and low-frequency or rare variants. In such scenarios, the statistic derived from hypothesis test using the classical statistical method, e.g., logistic regression model and Cox proportional hazard regression model, might deviate from theoretical asymptotic distribution, resulting in inflation or deflation of type I error. With the increased availability and exploration of resources from large-scale population cohorts in genome-wide association study (GWAS), there is a growing demand for effective and accurate statistical approaches to handle extremely unbalanced data in independent and non-independent samples. Our study introduces classical statistical methods in genetic statistics firstly, then, summarizes the failure of classical statistical methods in dealing with extremely unbalanced data through simulation experiments to draw researchers' attention to the extremely unbalanced data in GWAS.

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