Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

OBJECTIVE: Lipid oxidation is involved in the pathogenesis of atherosclerosis and may be contribute to the development of Ischemic stroke (IS). However, the lipid profiles associated with IS have been poorly studied. We conducted a pilot study to identify potential IS-related lipid molecules and pathways using lipidomic profiling. METHODS: Serum lipidomic profiling was performed using LC-MS in 20 patients with IS and 20 age- and sex-matched healthy controls. Univariate and multivariate analyses were simultaneously performed to identify the differential lipids. Multiple testing was controlled for using a false discovery rate (FDR) approach. Enrichment analysis was performed using MetaboAnalyst software. RESULTS: Based on the 294 lipids assayed, principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) models were used to distinguish patients with IS from healthy controls. Fifty-six differential lipids were identified with an FDR-adjusted P less than 0.05 and variable influences in projection (VIP) greater than 1.0. These lipids were significantly enriched in glycerophospholipid metabolism (FDR-adjusted P = 0.009, impact score = 0.216). CONCLUSIONS Serum lipid profiles differed significantly between patients with IS and healthy controls. Thus, glycerophospholipid metabolism may be involved in the development of IS. These results provide initial evidence that lipid molecules and their related metabolites may serve as new biomarkers and potential therapeutic targets for IS.
Humans ; Pilot Projects ; Lipidomics ; Male ; Female ; Biomarkers/blood* ; Middle Aged ; Ischemic Stroke/blood* ; Aged ; China ; Lipids/blood* ; Adult ; Case-Control Studies ; East Asian People

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

Aim To investigate the anti-acute lung injury(ALI)effect of Sterculiae Lychnophorae Semen(SLS)and its mechanism.Methods The main ac-tive components of SLS and their core targets and path-ways of action against ALI were obtained by network pharmacology methods.Subsequently,molecular doc-king technology and in vitro cellular experiments were applied for validation.Results A total of 19 core tar-gets were obtained,including HSP90AA1,CASP3,TNF,MAPK8 and MAPK14.The mechanisms may in-volve signaling pathways such as cancer,PI3K/Akt and MAPK.Molecular docking confirmed that the key targets of SLS formed a better binding activity with the relevant active ingredients.The in vitro results showed that SLS was able to protect the PM2.5-contaminated BEAS-2B cells,inhibit their NO,IL-1β and TNF-αlevels,and reduce the expression of p-p38 MAPK and p-JNK proteins.Conclusions The study successfully predicts the active ingredients,targets and signaling pathways of SLS against ALI,and in vitro experiments demonstrate that SLS might protect BEAS-2B cells from PM2.5 stimulus-induced inflammation and apoptosis by inhibiting the over-activation of p38 MAPK and JNK signaling pathways.

Objective:To analyze the treatment-free remission (TFR) outcomes after discontinuation of tyrosine kinase inhibitor (TKI) in children with chronic myeloid leukemia (CML).Methods:In this retrospective cohort study, clinical data of 14 chronic phase CML children aged <18 years who had achieved stable deep molecular response (DMR) for ≥ 2 years after standardized treatment with TKI and had a strong desire to discontinue TKI at Henan Cancer Hospital from September 30, 2016 to January 30, 2022 were collected retrospectively. According to the different TFR outcomes after discontinuation of TKI, patients were divided into loss of major molecular response (MMR) group and without loss of MMR group, differences in clinical characteristics between the two groups of children were analyzed using Mann-Whitney U test and Fisher exact test. Results:Out of 14 children with TKI discontinuation, 7 were male and 7 were female. The age at diagnosis was 14.0 (4.8, 17.0) years, and the age at TKI discontinuation was 22.0 (12.5, 27.0) years. Among them, 8 children were treated with imatinib prior to TKI discontinuation and 6 children were treated with second-line substitution of the second-generation TKI nilotinib or dasatinib prior to TKI discontinuation. The follow-up time was 37.0 (27.8, 47.5) months, and 7 cases lost MMR at the time of discontinuation of 3.0 (2.0, 11.0) months. Eight children gained TFR at 6 months, 7 children gained TFR at 12 and 24 months. Amongst the 6 children who received second-generation TKI prior to TKI discontinuation, 2 children lost MMR at 3 and 11 months and 4 children gained TFR, among the 8 children who discontinued imatinib, 5 children lost MMR at the time 3.0 (2.0, 9.0) months and 3 children gained TFR. The age at diagnosis and TKI discontinuation, the time from TKI treatment to the acquisition of DMR, the duration of TKI treatment before TKI discontinuation, the duration of DMR before TKI discontinuation, and the number of children treated with second-generation TKI were not statistically different between the 7 children in the group that did not lose the MMR and the 7 children in the group that lost the MMR (all P>0.05) . All the 7 children with confirmed loss of MMR immediately restarted TKI therapy, and all regained DMR after 2.0 (2.0, 11.0) months of therapy. None of the children had disease progression. After TKI discontinued, only 1 child had mild bone pain, which could be relieved by oral antipyretic analgesic drugs. Conclusions:Children with CML who have achieved a durable stable DMR for≥2 years on TKI therapy can discontinue the TKI and obtain TFR. Both the longer duration of TKI therapy, the longer duration of DMR and the use of second-generation TKI therapy before TKI discontinuation, may allow more children with CML who are expecting TKI discontinuation to have access to TFR.

AIM To study the protective effect of Gynura divaricate polysaccharide on gouty nephropathy(GN)induced by dry yeast combined with adenine in rats.METHODS Sixty male SD rats were randomly divided into the normal group,the model group,the allopurinol group(42 mg/kg),and the low-dose,medium-dose and high-dose G.divaricate polysaccharide groups(140,280,560 mg/kg).All the rats except those of the normal group were induced into GN models by intragastrical dosing of yeast(5 g/kg)and adenine(100 mg/kg)and intervened with corresponding drug administration simultaneously.After 35 days,the rats had their levels of creatinine(Cr)and uric acid(UA)in serum and urine detected and their fraction excretion of uric acid(FEUA)value determined;their kidney mass and volume measured and their levels of kidney index and density calculated;their renal pathological changes checked by HE staining;their renal GLUT9,URAT1,ABCG2 and OAT1 mRNA expressions dectected by RT-qPCR;and their renal GLUT9,URAT1,ABCG2 and OAT1 protein expressions dectected by Western blot.RESULTS Compared with the model group,each dose of G.divaricate polysaccharide group displayed decreased levels of kidney mass,kidney volume and kidney index(P＜0.01);increased levels of kidney density(P＜0.05,P＜0.01);decreased serum levels of UA and Cr(P＜0.01);increased urine levels of UA and Cr(P＜0.01);increased FEUA value(P＜0.01);decreased GLUT9,URAT1 mRNA and protein expressions(P＜0.05,P＜0.01);and increased ABCG2,OAT1 mRNA and protein expressions(P＜0.05,P＜0.01);and more alleviated renal histological aberrations.CONCLUSION G.divaricate polysaccharide exerts good protective effects against yeast/adenine-induced GN in rats probably through down-regulating protein expression of GLUT9,URAT1 and up-regulating ABCG2 and OAT1.

Objective:To explore the occupational adaptability of psychiatric medical caregivers from the perspective of a composite ecosystem.Methods:Using purposive sampling combining with snowball sampling and based on ecosystem theory, an interview outline was set up to conduct semi-structured interviews with psychiatric medical caregivers from October to December 2023. The Colaizzi 7-step analysis method was used to extract the themes.Results:Totally 15 psychiatric medical caregivers aged 44-61 years, 4 males and 11 females. There were three themes in the study: microsystems-changes in cognition, emotion, and physical and mental health; mid-level system-support and difficulties for families, hospitals, and nursing staff institutions; the macro system-social psychological support system was lacking.Conclusions:Psychiatric medical caregivers lack professional knowledge, have more negative emotions in their emotional experiences, and have a serious lack of mental health support systems. There are biases and misunderstandings towards them in society. It is recommended that managers pay attention to the physical and mental health of psychiatric caregivers and improve their work adaptability.

AIM To study the protective effect of Gynura divaricate polysaccharide on gouty nephropathy(GN)induced by dry yeast combined with adenine in rats.METHODS Sixty male SD rats were randomly divided into the normal group,the model group,the allopurinol group(42 mg/kg),and the low-dose,medium-dose and high-dose G.divaricate polysaccharide groups(140,280,560 mg/kg).All the rats except those of the normal group were induced into GN models by intragastrical dosing of yeast(5 g/kg)and adenine(100 mg/kg)and intervened with corresponding drug administration simultaneously.After 35 days,the rats had their levels of creatinine(Cr)and uric acid(UA)in serum and urine detected and their fraction excretion of uric acid(FEUA)value determined;their kidney mass and volume measured and their levels of kidney index and density calculated;their renal pathological changes checked by HE staining;their renal GLUT9,URAT1,ABCG2 and OAT1 mRNA expressions dectected by RT-qPCR;and their renal GLUT9,URAT1,ABCG2 and OAT1 protein expressions dectected by Western blot.RESULTS Compared with the model group,each dose of G.divaricate polysaccharide group displayed decreased levels of kidney mass,kidney volume and kidney index(P＜0.01);increased levels of kidney density(P＜0.05,P＜0.01);decreased serum levels of UA and Cr(P＜0.01);increased urine levels of UA and Cr(P＜0.01);increased FEUA value(P＜0.01);decreased GLUT9,URAT1 mRNA and protein expressions(P＜0.05,P＜0.01);and increased ABCG2,OAT1 mRNA and protein expressions(P＜0.05,P＜0.01);and more alleviated renal histological aberrations.CONCLUSION G.divaricate polysaccharide exerts good protective effects against yeast/adenine-induced GN in rats probably through down-regulating protein expression of GLUT9,URAT1 and up-regulating ABCG2 and OAT1.

Aim To investigate the anti-acute lung injury(ALI)effect of Sterculiae Lychnophorae Semen(SLS)and its mechanism.Methods The main ac-tive components of SLS and their core targets and path-ways of action against ALI were obtained by network pharmacology methods.Subsequently,molecular doc-king technology and in vitro cellular experiments were applied for validation.Results A total of 19 core tar-gets were obtained,including HSP90AA1,CASP3,TNF,MAPK8 and MAPK14.The mechanisms may in-volve signaling pathways such as cancer,PI3K/Akt and MAPK.Molecular docking confirmed that the key targets of SLS formed a better binding activity with the relevant active ingredients.The in vitro results showed that SLS was able to protect the PM2.5-contaminated BEAS-2B cells,inhibit their NO,IL-1β and TNF-αlevels,and reduce the expression of p-p38 MAPK and p-JNK proteins.Conclusions The study successfully predicts the active ingredients,targets and signaling pathways of SLS against ALI,and in vitro experiments demonstrate that SLS might protect BEAS-2B cells from PM2.5 stimulus-induced inflammation and apoptosis by inhibiting the over-activation of p38 MAPK and JNK signaling pathways.

Objective:To explore the occupational adaptability of psychiatric medical caregivers from the perspective of a composite ecosystem.Methods:Using purposive sampling combining with snowball sampling and based on ecosystem theory, an interview outline was set up to conduct semi-structured interviews with psychiatric medical caregivers from October to December 2023. The Colaizzi 7-step analysis method was used to extract the themes.Results:Totally 15 psychiatric medical caregivers aged 44-61 years, 4 males and 11 females. There were three themes in the study: microsystems-changes in cognition, emotion, and physical and mental health; mid-level system-support and difficulties for families, hospitals, and nursing staff institutions; the macro system-social psychological support system was lacking.Conclusions:Psychiatric medical caregivers lack professional knowledge, have more negative emotions in their emotional experiences, and have a serious lack of mental health support systems. There are biases and misunderstandings towards them in society. It is recommended that managers pay attention to the physical and mental health of psychiatric caregivers and improve their work adaptability.