1.Status of Clinical Practice Guideline Information Platforms
Xueqin ZHANG ; Yun ZHAO ; Jie LIU ; Long GE ; Ying XING ; Simeng REN ; Yifei WANG ; Wenzheng ZHANG ; Di ZHANG ; Shihua WANG ; Yao SUN ; Min WU ; Lin FENG ; Tiancai WEN
Medical Journal of Peking Union Medical College Hospital 2025;16(2):462-471
Clinical practice guidelines represent the best recommendations for patient care. They are developed through systematically reviewing currently available clinical evidence and weighing the relative benefits and risks of various interventions. However, clinical practice guidelines have to go through a long translation cycle from development and revision to clinical promotion and application, facing problems such as scattered distribution, high duplication rate, and low actual utilization. At present, the clinical practice guideline information platform can directly or indirectly solve the problems related to the lengthy revision cycles, decentralized dissemination and limited application of clinical practice guidelines. Therefore, this paper systematically examines different types of clinical practice guideline information platforms and investigates their corresponding challenges and emerging trends in platform design, data integration, and practical implementation, with the aim of clarifying the current status of this field and providing valuable reference for future research on clinical practice guideline information platforms.
2.Preliminary exploration of differentiating and treating multiple system atrophy from the perspective of the eight extraordinary meridians
Di ZHAO ; Zhigang CHEN ; Nannan LI ; Lu CHEN ; Yao WANG ; Jing XUE ; Xinning ZHANG ; Chengru JIA ; Xuan XU ; Kaige ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(3):392-397
Multiple system atrophy (MSA) is a rare neurodegenerative disease with complex clinical manifestations, presenting substantial challenges in clinical diagnosis and treatment. Its symptoms and the eight extraordinary meridians are potentially correlated; therefore, this article explores the association between MSA symptom clusters and the eight extraordinary meridians based on their circulation and physiological functions, as well as their treatment strategies. The progression from deficiency to damage in the eight extraordinary meridians aligns with the core pathogenesis of MSA, which is characterized by "the continuous accumulation of impacts from the vital qi deficiency leading to eventual damage". Liver and kidney deficiency and the emptiness of the eight extraordinary meridians are required for the onset of MSA; the stagnation of qi deficiency and the gradual damage to the eight extraordinary meridians are the key stages in the prolonged progression of MSA. The disease often begins with the involvement of the yin and yang qiao mai, governor vessel, thoroughfare vessel, and conception vessel before progressing to multiple meridian involvements, ultimately affecting all eight extraordinary meridians simultaneously. The treatment approach emphasizes that "the direct method may be used for joining battle, but indirect method will be needed in order to secure victory" and focuses on "eliminate pathogenic factors and reinforce healthy qi". Distinguishing the extraordinary meridians and focusing on the primary symptoms are pivotal to improving efficacy. Clinical treatment is aimed at the target, and tailored treatment based on careful clinical observation ensures precision in targeting the disease using the eight extraordinary meridians as the framework and core symptoms as the specific focus. Additionally, combining acupuncture, daoyin therapy, and other method may help prolong survival. This article classifies clinical manifestations based on the theory of the eight extraordinary meridians and explores treatment.
3.Herbal Textual Research on Zanthoxylum armatum and Zanthoxyli Radix in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Yapeng WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):252-262
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, harvesting and processing, and other aspects of Manjiao and Zanthoxyli Radix by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the relevant modern research materials, in order to provide a basis for the development of famous classical formulas containing the two medicinal materials. According to the herbal textual research, Manjiao was first recorded in Shennong Bencaojing of the Han dynasty with aliases such as Zhujiao, Goujiao and Zhijiao. Throughout history, Manjiao was sourced from the stems and roots of Zanthoxylum armatum in the Rutaceae family, and its leaves and fruits can also be used in medicine. The traditional recorded production area was mainly in Yunzhong(now Tuoketuo region in Inner Mongolia), with mentions in Zhejiang, Hunan, Fujian, Guangdong, Guangxi, Yunnan, Taiwan, and other provinces. Presently, this species is distributed from the south of Shandong, to Hainan, Taiwan, Tibet and other regions. The roots can be harvested year-round, while the fruits are harvested in autumn after maturity. In ancient times, the roots and stems were mostly used for brewing or soaking in wine, whereas nowadays, the roots are often sliced and then used as a raw material in traditional Chinese medicine, and the fruits should be stir-fried before use. Manjiao has a bitter taste and warm property, and was historically used to treat wind-cold dampness, joint pain, limb numbness, and knee pain. Modern researches have summarized its effects as dispelling wind, dispersing cold, promoting circulation, and relieving pain, and it is used for treating rheumatoid arthritis, toothache, bruises, as well as an anthelmintic. Zanthoxyli Radix initially known as Rudi Jinniugen, recorded in Bencao Qiuyuan of the Qing dynasty, with the alternate name of Liangbianzhen. In recent times, it is more commonly referred to as Liangmianzhen, sourced from the dried roots of Z. nitidum of the Rutaceae family, mainly produced in Guangxi and Guangdong. It can be harvested throughout the year, cleaned, sliced, and dried after harvesting. Zanthoxyli Radix is pungent, bitter, warm and slightly toxic, with the functions of promoting blood circulation, removing stasis, relieving pain, dispelling wind, and resolving swelling. Based on the results of herbal textual research, it is clarified that the ancient Manjiao and the modern Zanthoxyli Radix are not the same species. This article corrects the mistaken belief of by previous scholars that Zanthoxyli Radix is the same as ancient Manjiao, and suggests that formulas described as Manjiao should use Z. armatum as the medicinal herb, while those described as Liangmianzhen or Rudi Jinniu should use Z. nitidum. The processing was performed according to the processing requirements prescribed in the formulas, otherwise, the raw products are recommended for use.
4.Herbal Textual Research on Zanthoxylum armatum and Zanthoxyli Radix in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Yapeng WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):252-262
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, harvesting and processing, and other aspects of Manjiao and Zanthoxyli Radix by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the relevant modern research materials, in order to provide a basis for the development of famous classical formulas containing the two medicinal materials. According to the herbal textual research, Manjiao was first recorded in Shennong Bencaojing of the Han dynasty with aliases such as Zhujiao, Goujiao and Zhijiao. Throughout history, Manjiao was sourced from the stems and roots of Zanthoxylum armatum in the Rutaceae family, and its leaves and fruits can also be used in medicine. The traditional recorded production area was mainly in Yunzhong(now Tuoketuo region in Inner Mongolia), with mentions in Zhejiang, Hunan, Fujian, Guangdong, Guangxi, Yunnan, Taiwan, and other provinces. Presently, this species is distributed from the south of Shandong, to Hainan, Taiwan, Tibet and other regions. The roots can be harvested year-round, while the fruits are harvested in autumn after maturity. In ancient times, the roots and stems were mostly used for brewing or soaking in wine, whereas nowadays, the roots are often sliced and then used as a raw material in traditional Chinese medicine, and the fruits should be stir-fried before use. Manjiao has a bitter taste and warm property, and was historically used to treat wind-cold dampness, joint pain, limb numbness, and knee pain. Modern researches have summarized its effects as dispelling wind, dispersing cold, promoting circulation, and relieving pain, and it is used for treating rheumatoid arthritis, toothache, bruises, as well as an anthelmintic. Zanthoxyli Radix initially known as Rudi Jinniugen, recorded in Bencao Qiuyuan of the Qing dynasty, with the alternate name of Liangbianzhen. In recent times, it is more commonly referred to as Liangmianzhen, sourced from the dried roots of Z. nitidum of the Rutaceae family, mainly produced in Guangxi and Guangdong. It can be harvested throughout the year, cleaned, sliced, and dried after harvesting. Zanthoxyli Radix is pungent, bitter, warm and slightly toxic, with the functions of promoting blood circulation, removing stasis, relieving pain, dispelling wind, and resolving swelling. Based on the results of herbal textual research, it is clarified that the ancient Manjiao and the modern Zanthoxyli Radix are not the same species. This article corrects the mistaken belief of by previous scholars that Zanthoxyli Radix is the same as ancient Manjiao, and suggests that formulas described as Manjiao should use Z. armatum as the medicinal herb, while those described as Liangmianzhen or Rudi Jinniu should use Z. nitidum. The processing was performed according to the processing requirements prescribed in the formulas, otherwise, the raw products are recommended for use.
5.STAR Guideline Terminology(Ⅱ): Clinical Question Formulation, Evidence Retrieval and Appraisal, and Recommendation Development
Di ZHU ; Haodong LI ; Zijun WANG ; Qianling SHI ; Hui LIU ; Yishan QIN ; Yuanyuan YAO ; Zhewei LI ; Hongfeng HE ; Jinhui TIAN ; Long GE ; Yaolong CHEN ;
Medical Journal of Peking Union Medical College Hospital 2025;16(3):756-764
To introduce and analyze guideline terminology related to clinical question formulation, evidence retrieval and appraisal, and recommendation development. A systematic search was conducted in guideline development manuals and relevant methodological literature, covering publications up to October 25, 2024. Terminology related to the three aforementioned stages of related to guideline development was extracted from the included literature, standardized, and refined through consensus meetings to finalize a comprehensive terminology list and definitions. A total of 30 guideline development manuals and 15 methodological articles were included, and 23 core terms were identified. It is recommended to develop a standardized and scientifically sound guideline terminology system with unified naming, clear definitions, and alignment with the linguistic environment and usage habits in China. At the same time, it is essential to strengthen terminology training for both guideline developers and users based on this system, in order to deepen their correct understanding and proper application of guideline terminology.
6.Chaihu Shugansan Combined with Ferulic Acid Regulates BDNF/TrkB Signaling Pathway and Monoamine Neurotransmitters in Frontal Cortex of Rat Model of CUMS
Yuexin LI ; Zhijing ZHANG ; Ziyi GUO ; Di YAN ; Xueyan HU ; Jianping YAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):28-37
ObjectiveTo observe the antidepressant effect of Chaihu Shugansan combined with ferulic acid on the rat model of chronic unpredictable mild stress (CUMS) and explore the mechanism from the histomorphology of frontal cortex, expression of key molecules in the brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signaling pathway, and changes in monoamine neurotransmitter levels. MethodsSixty adult male SD rats were randomized into six groups (n=10): blank control, depression model, Chaihu Shugansan (3.3 g·kg-1·d-1), ferulic acid (50 mg·kg-1·d-1), Chaihu Shugansan (3.3 g·kg-1·d-1) + ferulic acid (50 mg·kg-1·d-1), and fluoxetine (2.1 mg·kg-1·d-1). Rats in other groups except the blank control group were subjected to a mild chronic unpredictable stress stimulus every day. Seven stimuli were used, including fasting with free access to water for 24 h, water deprivation with free access to food for 24 h, wetting the bedding with water in the cage, restraint for 3 h, tail clamping for 1 min, swimming in ice water at 4 ℃, and day and night reversal. Each stimulus was used 1 to 3 times, and the modeling lasted for a total of 21 days. At the same time of stimulation, rats in each medication group were treated with corresponding agents by gavage, while those in the blank control group and the depression model group received equal volumes of normal saline by gavage. The open field test, sucrose preference test, and forced swimming test were conducted before and after modeling. The rats were anesthetized by intraperitoneal injection of 3% pentobarbital sodium, and the frontal cortex was isolated on ice. The mRNA and protein levels of BDNF, TrkB, and cyclic adenosine monophosphate-responsive element-binding protein (CREB) in the frontal cortex were determined by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot, respectively. The levels of monoamine neurotransmitters 5-hydroxytryptamine (5-HT), dopamine (DA), and norepinephrine (NE) in the frontal cortex were determined by enzyme-linked immunosorbent assay. Light microscopy was employed to observe the histopathological changes in the frontal cortex. ResultsCompared with the blank control group, the depression model group showed reduced body mass (P<0.05, P<0.01), decreased number of crossings and rearings in the open field test and sucrose preference (P<0.01), prolonged time of immobility in the forced swimming test (P<0.01), reduced neuronal cells, increased necrotic cells, and darkening cell staining in the frontal cortex, down-regulated mRNA and protein levels of BDNF, TrkB, CREB, and lowered levels of 5-HT, NE, and DA in the frontal cortex (P<0.01). Compared with the depression model group, each intervention group showed improved general state, increased body mass (P<0.05), increased number of crossings (P<0.05), shortened immobility time in the forced swimming test (P<0.01), increased neuronal cells, reduced necrotic cells, and lightened cellular staining in the frontal cortex, up-regulated mRNA and protein levels of BDNF, TrkB and CREB, and elevated levels of 5-HT, NE, and DA in the frontal cortex (P<0.01). Moreover, the Chaihu Shugansan + ferulic acid group outperformed the Chaihu Shugansan group and the ferulic acid group in increasing the body mass and the 5-HT content in the frontal cortex (P<0.05). The combination group outperformed the Chaihu Shugansan group regarding the number of rearings and up-regulation in the mRNA level of BDNF in the frontal cortex (P<0.05), and it was superior to the ferulic acid group in terms of shortening the immobility time in the forced swimming test, up-regulating the mRNA levels of BDNF, TrkB, and CREB and the protein levels of BDNF and CREB in the frontal cortex, and increasing the DA content in the frontal cortex (P<0.05). ConclusionChaihu Shugansan combined with ferulic acid can exert antidepressant effect on the rat model of CUMS by regulating the BDNF/TrkB signaling pathway and monoamine neurotransmitter content in the frontal cortex. Moreover, the antidepressant effect of Chaihu Shugansan combined with ferulic acid was more significant than that of Chaihu Shugansan and ferulic acid used alone.
7.Herbal Textual Research on Abri Herba and Abri Mollis Herba in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):193-201
This article systematically analyzes the historical evolution of the name, origin, academic name, medicinal parts, origin, harvesting, processing and other aspects of Abri Herba and Abri Mollis Herba by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the modern literature, so as to provide a basis for the development of famous classical formulas containing this type of medicinal materials. According to the herbal textual research, Abri Herba was first recorded in Lingnan Caiyaolu, with other aliases such as Huangtoucao and Xiye Longlincao. It originates from the dried whole plant of Abrus cantoniensis, a Fabaceae plant, which can be used medicinally except for its fruits. Currently, this species is mainly distributed in Guangdong and Guangxi, and also found in Hunan and Thailand, it can be harvested throughout the year, mainly in spring and autumn. The roots, stems, and leaves can be used for medicinal purposes, but the pods are toxic and need to be removed. After harvesting, impurities and pods are removed, and it is dried and processed for medicinal use. Abri Herba has a sweet and slightly bitter taste, is cool in nature, and is associated with the liver and stomach meridians, it is used for clearing heat and relieving dampness, dispersing blood stasis and relieving pain, and is mainly used to treat jaundice-type hepatitis, stomach pain, rheumatic bone pain, contusion and ecchymosis pain, and mastitis. Abri Mollis Herba was first recorded in the 1982 edition of Zhongyaozhi as another origin for Abri Herba, and was singled out in some monographs such as Xinhua Bencao Gangyao in 1988 for use, while some other monographs use it as a local habitual products or confused products of Abri Herba with aliases such as Daye Jigucao, Qingtingteng, and Maoxiangsi. It comes from the dried whole herb of A. mollis without pods, and is mainly produced in Guangxi and Guangdong, and occasionally found in Hong Kong, Hainan and Fujian. The collection and processing are similar to Abri Herba, after harvesting, impurities and pods are removed, and it is dried and cut for medicinal use. Abri Mollis Herba has a sweet and light taste, is cool in nature, and is associated with the liver and stomach meridians, with the efficacy of clearing heat and detoxifying, and promoting dampness, it is mainly used to treat infectious hepatitis, mastitis, furuncles, burns and scalds, and pediatric malnutrition. Based on the research, A. mollis was first recorded to be used as a medicine in the same origin as A. cantoniensis, and as plants of the same genus, have similar morphological characteristics, and their medicinal parts, collection and processing, properties and flavors, and meridian affiliations are consistent. And in the folk, Abri Mollis Herba is often used as Abri Herba, which has been used for a long time and is now dominated by the cultivation of A. mollis. So it is recommended that the subsequent version of Chinese Pharmacopoeia should include A. mollis in the origin of Abri Herba, and it is also recommended that in famous classical formulas refered to Jiguccao can use A. cantoniensis and A. mollis as the sources of the herb, refered to Mao Jiguccao can use A. mollis as the sources of the herb. Processing is carried out according to the requirements specified in the original formulas, and raw products are recommended to be included in the medicine if there are no requirements.
8.Herbal Textual Research on Abri Herba and Abri Mollis Herba in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):193-201
This article systematically analyzes the historical evolution of the name, origin, academic name, medicinal parts, origin, harvesting, processing and other aspects of Abri Herba and Abri Mollis Herba by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the modern literature, so as to provide a basis for the development of famous classical formulas containing this type of medicinal materials. According to the herbal textual research, Abri Herba was first recorded in Lingnan Caiyaolu, with other aliases such as Huangtoucao and Xiye Longlincao. It originates from the dried whole plant of Abrus cantoniensis, a Fabaceae plant, which can be used medicinally except for its fruits. Currently, this species is mainly distributed in Guangdong and Guangxi, and also found in Hunan and Thailand, it can be harvested throughout the year, mainly in spring and autumn. The roots, stems, and leaves can be used for medicinal purposes, but the pods are toxic and need to be removed. After harvesting, impurities and pods are removed, and it is dried and processed for medicinal use. Abri Herba has a sweet and slightly bitter taste, is cool in nature, and is associated with the liver and stomach meridians, it is used for clearing heat and relieving dampness, dispersing blood stasis and relieving pain, and is mainly used to treat jaundice-type hepatitis, stomach pain, rheumatic bone pain, contusion and ecchymosis pain, and mastitis. Abri Mollis Herba was first recorded in the 1982 edition of Zhongyaozhi as another origin for Abri Herba, and was singled out in some monographs such as Xinhua Bencao Gangyao in 1988 for use, while some other monographs use it as a local habitual products or confused products of Abri Herba with aliases such as Daye Jigucao, Qingtingteng, and Maoxiangsi. It comes from the dried whole herb of A. mollis without pods, and is mainly produced in Guangxi and Guangdong, and occasionally found in Hong Kong, Hainan and Fujian. The collection and processing are similar to Abri Herba, after harvesting, impurities and pods are removed, and it is dried and cut for medicinal use. Abri Mollis Herba has a sweet and light taste, is cool in nature, and is associated with the liver and stomach meridians, with the efficacy of clearing heat and detoxifying, and promoting dampness, it is mainly used to treat infectious hepatitis, mastitis, furuncles, burns and scalds, and pediatric malnutrition. Based on the research, A. mollis was first recorded to be used as a medicine in the same origin as A. cantoniensis, and as plants of the same genus, have similar morphological characteristics, and their medicinal parts, collection and processing, properties and flavors, and meridian affiliations are consistent. And in the folk, Abri Mollis Herba is often used as Abri Herba, which has been used for a long time and is now dominated by the cultivation of A. mollis. So it is recommended that the subsequent version of Chinese Pharmacopoeia should include A. mollis in the origin of Abri Herba, and it is also recommended that in famous classical formulas refered to Jiguccao can use A. cantoniensis and A. mollis as the sources of the herb, refered to Mao Jiguccao can use A. mollis as the sources of the herb. Processing is carried out according to the requirements specified in the original formulas, and raw products are recommended to be included in the medicine if there are no requirements.
9. Advances in relationship between pyroptosis and pulmonary arterial hypertension and therapeutic drugs
Qian YAN ; Yang SUN ; Jun-Peng LONG ; Jiao YAO ; Yu-Ting LIN ; Song-Wei YANG ; Yan-Tao YANG ; Gang PEI ; Qi-Di AI ; Nai-Hong CHEN ; Qian YAN ; Yang SUN ; Jun-Peng LONG ; Jiao YAO ; Yu-Ting LIN ; Song-Wei YANG ; Yan-Tao YANG ; Gang PEI ; Qi-Di AI ; Nai-Hong CHEN ; Sha-Sha LIU ; Nai-Hong CHEN
Chinese Pharmacological Bulletin 2024;40(1):25-30
Pyroptosis is the programmed death of cells accompanied by an inflammatory response and is widely involved in the development of a variety of diseases, such as infectious diseases, cardiovascular diseases, and neurodegeneration. It has been shown that cellular scorching is involved in the pathogenesis of pulmonary arterial hypertension ( PAH) in cardiovascular diseases. Patients with PAH have perivascular inflammatory infiltrates in lungs, pulmonary vasculopathy exists in an extremely inflam-matory microenvironment, and pro-inflammatory factors in cellular scorching drive pulmonary vascular remodelling in PAH patients. This article reviews the role of cellular scorch in the pathogenesis of PAH and the related research on drugs for the treatment of PAH, with the aim of providing new ideas for clinical treatment of PAH.
10.Research progress on impact of compound hot-dry events on incidence of infectious diseases
Di WANG ; Xiaoni CHI ; Zishan HUANG ; Yizhen YAO ; Yi LIN ; Jianxiong HU ; Tao LIU ; Wenjun MA ; Guanhao HE
Journal of Environmental and Occupational Medicine 2024;41(8):925-933
Climate change has led to an increasing frequency and intensity of extreme climate events such as heat and drought extremes with considerable global public health burden. This systematic review collected 87 domestic and international studies from 2000 to 2023, considering the impacts of heat extremes, drought extremes, and compound hot-dry events on infectious diseases attributable to various transmission pathways such as waterborne, foodborne, insect-borne, airborne, and contact-transmitted diseases. Our results showed that high temperature was associated with increased transmission risks of waterborne and foodborne diseases including infectious diarrheal diseases (cholera, dysentery, typhoid, and paratyphoid) and infectious gastroenteritis; vector-borne diseases including dengue fever, Zika virus (ZIKV) disease, chikungunya fever, malaria, West Nile fever, and Rift Valley fever; airborne diseases including influenza-like diseases, influenza A, measles, and mumps; and contact-transmitted diseases including HIV/AIDS, schistosomiasis, and leptospirosis. Additionally, drought conditions also amplified the transmission risks of waterborne and foodborne diseases including cholera, Escherichia coli infection, rotavirus infection, and hepatitis E; vector-borne diseases such as scrub typhus, schistosomiasis, hemorrhagic fever with renal syndrome, and West Nile fever; airborne diseases including meningococcal meningitis, pertussis, measles, and upper respiratory infections; and contact-transmitted diseases such as HIV/AIDS. Along with global warming, the frequency of compound high temperature and drought events shows a considerably increasing trend, causing more adverse health effects than heat or drought alone. However, there is limited research quantifying their effects on infectious diseases. These associations may be mediated through temperature and precipitation on infectious disease pathogens, transmission vectors, population susceptibility, public health services, and behaviors. In the context of climate change, the increasing occurrence of compound events of high temperatures and droughts raises health concerns, and further studies are needed to enhance our understanding of the impacts of climate change on infectious diseases and improve human adaption to climate change.


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