1.Mechanism of Danggui Shaoyaosan in Improving Glomerulosclerosis in db/db Mice via SIRT1/HIF-1α/VLDLr Signaling Pathway
Ruijia LI ; Zixuan WANG ; Shilong GUO ; Jing LI ; Qianqian ZHANG ; Wen DONG ; Dengzhou GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):11-18
ObjectiveTo investigate the potential mechanism of Danggui Shaoyaosan (DSS) in ameliorating renal injury in db/db mice. MethodsThirty 8-week-old specific pathogen-free (SPF)-grade male db/db mice and six db/m mice were acclimated for one week. Urinary microalbumin and blood glucose levels were measured weekly in both db/db and db/m mice. Successful modeling was determined by significantly higher microalbuminuria in db/db mice compared to db/m mice and a fasting blood glucose ≥16.7 mmol·L-1. The 30 db/db mice were randomly divided into five groups: the model group, the irbesartan (IBN) group, and three DSS dose groups (low-, medium-, and high-dose DSS groups, administered at 16.77, 33.54, 67.08 g·kg-1·d-1, respectively). Additionally, the six db/m mice served as the normal control group. The IBN group received irbesartan at 0.025 g·kg-1·d-1 by gavage, while the three DSS groups received DSS at 16.77, 33.54, and 67.08 g·kg-1·d-1 by gavage, respectively. The normal and model groups were administered with an equivalent volume of normal saline by gavage. All interventions lasted for 8 consecutive weeks. After intervention, serum creatinine (SCr), blood urea nitrogen (BUN), urinary total protein (UTP), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were measured to evaluate the therapeutic efficacy of the treatments. Renal histopathological changes were observed with hematoxylin-eosin (HE) staining. Western blot was used to detect the protein expression of silencing information regulator 1 (SIRT1), hypoxia-inducible factor-1α (HIF-1α), very low-density lipoprotein receptor (VLDLr), and cluster of differentiation 31 (CD31). Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA levels of HIF-1α and VLDLr. Immunohistochemistry was used to observe the expression and distribution of HIF-1α and Caspase-3. ResultsCompared to the normal group, the model group showed significantly increased SCr, BUN, UTP, TG, and LDL-C. HE staining revealed glomerulosclerosis, mesangial matrix hyperplasia, capillary loop distortion and thickening, with extensive inflammatory cell infiltration. Protein expression of SIRT1 and CD31 significantly decreased (P<0.05), while HIF-1α and VLDLr protein and mRNA levels increased (P<0.05). Immunohistochemistry showed increased expression of HIF-1α and Caspase-3 (P<0.05), indicating hypoxia and apoptosis in renal cells. In all treatment groups, SCr, BUN, TG, and LDL-C were significantly reduced compared to the model group (P<0.05), and UTP was significantly improved in the medium-dose DSS group (P<0.05). Renal tissue structure and morphology were improved, inflammatory cells were reduced, and no vascular hyaline degeneration was observed. SIRT1 and CD31 protein expression was elevated to varying degrees compared to the model group (P<0.05), while HIF-1α and VLDLr protein and mRNA levels decreased (P<0.05). Immunohistochemistry showed reduced expression of HIF-1α and Caspase-3 in all treatment groups (P<0.05), with the most significant improvement observed in the IBN group and medium-dose DSS group (P<0.05). ConclusionDSS can effectively ameliorate glomerulosclerosis and lipid deposition in db/db mice, and its mechanism may involve the SIRT1/HIF-1α/VLDLr signaling pathway.
2.Protective Effect and Potential Mechanism of Danggui Shaoyaosan on Diabetic Kidney Disease in db/db Mice Based on Endoplasmic Reticulum Stress in Glomerular Endothelial Cells
Ruijia LI ; Zixuan WANG ; Shilong GUO ; Sen YANG ; Jing LI ; Qianqian ZHANG ; Wen DONG ; Dengzhou GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):28-35
ObjectiveTo investigate the therapeutic efficacy of Danggui Shaoyaosan (DSS) on renal injury in db/db mice and its impact on endoplasmic reticulum stress (ERS) in renal tissues. MethodsThirty 8-week-old male db/db mice and six db/m mice were acclimated for one week, after which urinary microalbumin and blood glucose levels were monitored to establish a diabetic kidney disease (DKD) model. The model mice were randomly divided into a model group, an irbesartan group, and three DSS treatment groups with different doses (16.77, 33.54, and 67.08 g·kg-1·d-1). A normal group was set as control. Each group was intragastrically administered with the corresponding drugs or saline for 8 weeks. After the intervention, general conditions were observed. Serum cystatin C (Cys-C), 24-hour urinary total protein (24 h-UTP), 24-hour urinary microalbumin (24 h-UMA), urinary creatinine (Ucr), and urea nitrogen (UUN) were measured. Transmission electron microscopy (TEM) was used to observe glomerular basement membrane (GBM) and ultrastructural changes of the endoplasmic reticulum (ER) in glomerular endothelial cells. Western blot, real-time fluorescence quantitative polymerase chain reaction (Real-time PCR), and immunohistochemistry were used to analyze renal tissue structure and the expression of GRP78, CHOP, and related markers. ResultsCompared with the normal group, the mice in the model group showed curled posture, sluggish response, poor fur condition, increased levels of Cys-C, 24 h-UTP, 24 h-UMA, and UUN (P<0.05), while Ucr decreased (P<0.05). The GBM was significantly thickened, with podocyte and foot process fusion. The protein expressions of GRP78, CHOP, and ATF6 were significantly upregulated (P<0.05), the mRNA levels of GRP78 and CHOP increased (P<0.05), and immunohistochemistry showed an enhanced GRP78 signal (P<0.05). After treatment, the mice exhibited improved behavior, normalized GBM and podocyte structure, improved ER morphology and markedly better biochemical indicators. Western blot, Real-time PCR, and immunohistochemistry indicated that the ERS-related markers were downregulated in the DSS treatment groups (P<0.05), suggesting alleviated ERS and improved renal function. ConclusionDSS can effectively ameliorate renal pathological damage in db/db mice, possibly by regulating ERS in glomerular endothelial cells, although the underlying signaling mechanisms require further investigation.
3.Chronic hepatitis B long-term antiviral therapy:Reflections on suboptimal response and low-level viremia
Xin WEI ; Lilong CONG ; Linmei YAO ; Zixuan GAO ; Shuojie WANG ; Ziyu ZHANG ; Xinxin LI ; Shiyu WANG ; Wen DENG ; Minghui LI
Chinese Journal of Experimental and Clinical Virology 2025;39(4):518-525
Chronic hepatitis B(CHB)is one of the major challenges in the global public health field. As of 2022,approximately 254 million people worldwide were infected with the hepatitis B virus(HBV). CHB is one of the main causes of liver cirrhosis and hepatocellular carcinoma(HCC). Nucleos(t)ide analogs(NAs)and interferon therapy can delay the progression of liver fibrosis by inhibiting viral replication,but they cannot completely avoid the problem of heterogeneous treatment responses. Some patients are in a state of low-level viremia(LLV)during treatment. The persistent LLV state can induce chronic inflammation and the progression of liver fibrosis,ultimately increase the risk of HCC. In patients with poor treatment responses,the continuous active viral replication can induce immune disorders,accelerate the evolution of fibrosis to the decompensated stage of liver cirrhosis,and increase the risk of patient death. This article aims to review the definition,mechanisms,and impact on treatment outcomes of LLV and suboptimal response based on the latest research,provide a basis for optimizing antiviral therapy for CHB.
4.Localization of"physician-pharmacist co-management"in chronic respiratory diseases:concepts,im-plementation pathways,and preliminary outcomes
Yingying XIAO ; Bingqin WEN ; Xiao MENG ; Zhipeng WANG ; Huiyin XU ; Yongbang CHEN ; Zixuan LIU ; Pengjiu YU ; Rongchang CHEN ; Liang PENG ; Li WEI
Modern Hospital 2025;25(11):1644-1647
With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24%,the annual rate of acute exacerbation-related hospitalizations declined by about 72%,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37%to 64.41%,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.
5.Legal issues and countermeasures of brain-computer interface
Wen JIANG ; Bingzhuo LIU ; Zixuan LUO
Modern Hospital 2025;25(3):339-341,345
Brain computer interface is faced with the problems of legal attribute,legal risk and legal liability.In terms of legal attributes,the user has the subject status,and the legal attributes of brain-computer interface should be judged according to integration degree between brain-computer interface and human body.In terms of legal risks,personal risks,confidentiality risks and exceptions to confidentiality must be analyzed.In terms of legal liabilities,whether the brain-computer interface equipment is faulty will affect the identification of civil liabilities.Legal interest is determined according to the legal attribute of brain-computer interface.When the brain-computer interface does not feedback the user's true will,the corresponding action does not constitute an act in criminal law.It is necessary for China to formulate"Human brain Computer Interface Management Regulations"to es-tablish the legislative purpose and basis,concept and classification,legal status,basic principles,informed consent rules,confi-dentiality rules and exception rules,and legal liability.
6.Localization of"physician-pharmacist co-management"in chronic respiratory diseases:concepts,im-plementation pathways,and preliminary outcomes
Yingying XIAO ; Bingqin WEN ; Xiao MENG ; Zhipeng WANG ; Huiyin XU ; Yongbang CHEN ; Zixuan LIU ; Pengjiu YU ; Rongchang CHEN ; Liang PENG ; Li WEI
Modern Hospital 2025;25(11):1644-1647
With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24%,the annual rate of acute exacerbation-related hospitalizations declined by about 72%,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37%to 64.41%,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.
7.Legal issues and countermeasures of brain-computer interface
Wen JIANG ; Bingzhuo LIU ; Zixuan LUO
Modern Hospital 2025;25(3):339-341,345
Brain computer interface is faced with the problems of legal attribute,legal risk and legal liability.In terms of legal attributes,the user has the subject status,and the legal attributes of brain-computer interface should be judged according to integration degree between brain-computer interface and human body.In terms of legal risks,personal risks,confidentiality risks and exceptions to confidentiality must be analyzed.In terms of legal liabilities,whether the brain-computer interface equipment is faulty will affect the identification of civil liabilities.Legal interest is determined according to the legal attribute of brain-computer interface.When the brain-computer interface does not feedback the user's true will,the corresponding action does not constitute an act in criminal law.It is necessary for China to formulate"Human brain Computer Interface Management Regulations"to es-tablish the legislative purpose and basis,concept and classification,legal status,basic principles,informed consent rules,confi-dentiality rules and exception rules,and legal liability.
8.Chronic hepatitis B long-term antiviral therapy:Reflections on suboptimal response and low-level viremia
Xin WEI ; Lilong CONG ; Linmei YAO ; Zixuan GAO ; Shuojie WANG ; Ziyu ZHANG ; Xinxin LI ; Shiyu WANG ; Wen DENG ; Minghui LI
Chinese Journal of Experimental and Clinical Virology 2025;39(4):518-525
Chronic hepatitis B(CHB)is one of the major challenges in the global public health field. As of 2022,approximately 254 million people worldwide were infected with the hepatitis B virus(HBV). CHB is one of the main causes of liver cirrhosis and hepatocellular carcinoma(HCC). Nucleos(t)ide analogs(NAs)and interferon therapy can delay the progression of liver fibrosis by inhibiting viral replication,but they cannot completely avoid the problem of heterogeneous treatment responses. Some patients are in a state of low-level viremia(LLV)during treatment. The persistent LLV state can induce chronic inflammation and the progression of liver fibrosis,ultimately increase the risk of HCC. In patients with poor treatment responses,the continuous active viral replication can induce immune disorders,accelerate the evolution of fibrosis to the decompensated stage of liver cirrhosis,and increase the risk of patient death. This article aims to review the definition,mechanisms,and impact on treatment outcomes of LLV and suboptimal response based on the latest research,provide a basis for optimizing antiviral therapy for CHB.
9.Efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with advanced hepatocellular carcinoma
Long CHENG ; Yue ZHANG ; Yushen LIU ; Zhaoqing DU ; Zhaoyang GUO ; Yangwei FAN ; Ting LI ; Xu GAO ; Enrui XIE ; Zixuan XING ; Wenhua WU ; Yinying WU ; Mingbo YANG ; Jie LI ; Yu ZHANG ; Wen KANG ; Wenjun WANG ; Fanpu JI ; Jiang GUO ; Ning GAO
Journal of Clinical Hepatology 2024;40(10):2034-2041
Objective To investigate the efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with unresectable or advanced hepatocellular carcinoma(HCC).Methods A retrospective analysis was performed for the patients with unresectable/advanced HCC who attended six hospitals from January 1,2019 to March 31,2021,and all patients received camrelizumab monoclonal antibody treatment,among whom 84.8%also received targeted therapy.According to the age of the patients,they were divided into elderly group(≥65 years)and non-elderly group(<65 years).The two groups were assessed in terms of overall survival(OS),progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),and immune-related adverse events(irAE).The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups;the independent samples t-test was used for comparison of normally distributed continuous data,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups.The Kaplan-Meier method was used for survival analysis,and the log-rank test was used for comparison of survival curves.Univariate and multivariate Cox proportional hazards regression analyses were used to determine the independent influencing factors for PFS and DCR at 6 months.Results A total of 99 HCC patients were enrolled,with 27 in the elderly group and 72 in the non-elderly group.The elderly group had an OS rate of 67.8%,an ORR of 44.4%,and a DCR of 74.1%at 12 months and a median PFS of 6.4(95%confidence interval[CI]:3.0-12.4)months,with no significant differences compared with the non-elderly group(all P>0.05).The median OS was unavailable for the elderly group,while the non-elderly group had an OS of 18.9(95%CI:13.0-24.8)months;there was no significant difference between the two groups(P=0.485).The univariate and multivariate Cox regression analyses showed that major vascular invasion(MVI)was an independent risk factor for PFS(hazard ratio[HR]=2.603,95%CI:1.136-5.964,P=0.024)and DCR(HR=3.963,95%CI:1.671-9.397,P=0.002)at 6 months,while age,sex,etiology of HBV infection,presence of extrahepatic metastasis,Child-Pugh class B,and alpha-fetoprotein>400 ng/mL were not associated with PFS or DCR at 6 months.For the elderly group,the incidence rates of any irAE and grade 3/4 irAE were 51.9%and 25.9%,respectively,with no significant differences compared with the non-elderly group(P>0.05),and skin disease was the most common irAE in both groups(39.4%).Conclusion Camrelizumab monoclonal antibody combined with molecular-targeted therapy has similar efficacy and safety in patients with unresectable/advanced HCC aged≥65 years and those aged<65 years.MVI is associated with suboptimal response to immunotherapy and poor prognosis.
10.Analysis on Children's Health Equity in Countries along the"Belt and Road"Based on Concentration Index and Thiel Index
Linhong LI ; Zeyu TAN ; Xinyi ZHANG ; Zixuan WEN ; Tongtong GUO ; Zewen XU ; Qi JING ; Wengui ZHENG
Chinese Health Economics 2024;43(2):49-52
Objective:To analyze and evaluate the equity of children's health in countries along the"the Belt and Road",promote further attention to children's health in countries along the route,and promote cooperation and exchanges on children's health between China and countries along the"the Belt and Road".Methods:Using concentration index and concentration curve to measure overall equity,and using the Thiel index for intraregional and interregional euqity measurement.Results:The under-five mortality concentration index is 0.349 7,the concentration curve is below the absolute fair line.The Thiel index shows that inequality in low-income countries,lower-middle-income countries,upper-middle-income countries and high-income countries is the leading cause of child health inequities in the"the Belt and Road"countries.Conclusion:There is inequity in the health of children in countries along"the Belt and Road Initiative",countries along the"the Belt and Road"should take comprehensive measures to reduce the under-five mortality rate,at the same time strengthen international cooperation to further promote equity in children's health in"Belt and Road"countries.

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