1.Analysis of the evaluation mechanism and methodology of clinical comprehensive evaluation cases of drugs in China
Yuan QIAO ; Fangyi MA ; Yubei HAN ; Mingyue ZHAO ; Minghuan JIANG ; Yu FANG
China Pharmacy 2025;36(2):146-153
OBJECTIVE To sort out the evaluation mechanism and methodology of published cases of comprehensive clinical evaluation of drugs in China, and provide a reference for promoting standardized comprehensive clinical evaluation of drugs and strengthening policy transformation in China. METHODS Clinical comprehensive evaluation cases of drugs published in China from CNKI, Wanfang Data, PubMed and Web of Science were systematically searched, and the retrieval time was from the inception to December 31st, 2023. The summary and analysis were performed from the aspects of theme selection, indicator system construction, evaluation methods, comprehensive decision-making, quality control, etc. RESULTS A total of 143 pieces of literature were ultimately included from 2014 to 2023. The number of publications has shown a rapid upward trend since 2019. The subjects of the evaluation cases were mainly pediatric drugs, Chinese patent medicines, cardiovascular drugs and anti-tumor drugs. The evaluation dimensions were between 3-8, all involving safety and effectiveness dimensions. Most cases adopted rapid evaluation methods based on literature review and expert interviews/questionnaire surveys with less emphasis on real-world research. Most cases did not involve comprehensive decision-making, quality control, or policy transformation. CONCLUSIONS The clinical comprehensive evaluation of drugs in China has made rapid progress under the guidance of national policies. However, there are still issues and challenges such as incomplete evaluation methods and standards, few cases of evaluation results being converted into decision-making, and a lack of quality control mechanisms. It is suggested that standardized evaluation paths and quality control mechanisms should be explored; when the evidence-based basis is insufficient, real-world research should be conducted as much as possible, so as to accelerate the policy transformation of evaluation results.
2.Analysis of the evaluation mechanism and methodology of clinical comprehensive evaluation cases of drugs in China
Yuan QIAO ; Fangyi MA ; Yubei HAN ; Mingyue ZHAO ; Minghuan JIANG ; Yu FANG
China Pharmacy 2025;36(2):146-153
OBJECTIVE To sort out the evaluation mechanism and methodology of published cases of comprehensive clinical evaluation of drugs in China, and provide a reference for promoting standardized comprehensive clinical evaluation of drugs and strengthening policy transformation in China. METHODS Clinical comprehensive evaluation cases of drugs published in China from CNKI, Wanfang Data, PubMed and Web of Science were systematically searched, and the retrieval time was from the inception to December 31st, 2023. The summary and analysis were performed from the aspects of theme selection, indicator system construction, evaluation methods, comprehensive decision-making, quality control, etc. RESULTS A total of 143 pieces of literature were ultimately included from 2014 to 2023. The number of publications has shown a rapid upward trend since 2019. The subjects of the evaluation cases were mainly pediatric drugs, Chinese patent medicines, cardiovascular drugs and anti-tumor drugs. The evaluation dimensions were between 3-8, all involving safety and effectiveness dimensions. Most cases adopted rapid evaluation methods based on literature review and expert interviews/questionnaire surveys with less emphasis on real-world research. Most cases did not involve comprehensive decision-making, quality control, or policy transformation. CONCLUSIONS The clinical comprehensive evaluation of drugs in China has made rapid progress under the guidance of national policies. However, there are still issues and challenges such as incomplete evaluation methods and standards, few cases of evaluation results being converted into decision-making, and a lack of quality control mechanisms. It is suggested that standardized evaluation paths and quality control mechanisms should be explored; when the evidence-based basis is insufficient, real-world research should be conducted as much as possible, so as to accelerate the policy transformation of evaluation results.
3.Effects of different storage temperatures and durations on the activity of coagulation factor Ⅷ and Ⅸ in whole blood
Hehe WANG ; Tiantian WANG ; Jie WANG ; Cuicui QIAO ; Wei LIU ; Xueqin ZHANG ; Yan CHENG ; Yunhai FANG ; Xinsheng ZHANG
Chinese Journal of Blood Transfusion 2025;38(6):824-827
Objective: To investigate the effects of different storage temperatures and durations on the activities of coagulation factor Ⅷ (Factor Ⅷ, FⅧ) and coagulation factor Ⅸ (Factor Ⅸ, FⅨ) after whole blood collection, so as to provide data support for the optimal storage conditions. Methods: A total of 16 mL of whole blood was collected from each of the 20 healthy volunteers at our blood center and aliquoted into 8 sodium citrate anticoagulant tubes. Two tubes were immediately centrifuged for the measurement of FⅧ and FⅨ activity levels. The remaining 6 tubes of whole blood were respectively stored under room temperature and low-temperature conditions. At 2, 4, and 6 h, the whole blood samples were centrifuged and analyzed for FⅧ and FⅨ activity levels. The mean values of the two immediately tested tubes were used as the control group, while other tubes were designated as the experimental groups for comparison. Statistical analysis was performed using SPSS 26.0. Results: The activity of FⅧ in whole blood remained stable after 4 hours of storage at both room temperature and low temperature (116.53±25.95 vs 125.22±27.33, 109.77±23.23 vs 125.22±27.33) (P>0.05 for both). However, by 6 hours, FⅧ activity showed a statistically significant decline compared to the control group (108.65±22.92 vs 125.22±27.33, 100.46±20.19 vs 125.22±27.33) (P<0.05 for both), though the room temperature group results were closer to the control values. The activity of FⅨ in whole blood remained stable after 6 hours of storage under both conditions (97.14±19.48 vs 96.76±19.67, 97.10±17.45 vs 96.76±19.6) (P>0.05 for all comparisons). Conclusion: For whole blood samples after collection, storage at either room temperature or low temperature for up to 4 hours does not compromise the accuracy of test results. When stored for 6 hours, FⅨ activity remains stable, whereas FⅧ activity decreases significantly. Notably, FⅧ activity demonstrates better stability at room temperature than under low-temperature conditions within the 6-hour storage.
4.Correlation between APTT mixing test results and inhibitor titers in patients with hemophilia A inhibitor
Tiantian WANG ; Yan CHENG ; Hehe WANG ; Cuicui QIAO ; Jie WANG ; Guangshang ZHONG ; Xiyuan WANG ; Xueqin ZHANG ; Yunhai FANG
Chinese Journal of Blood Transfusion 2025;38(9):1172-1176
Objective: To study the correlation between activated partial thromboplastin time (APTT) mixing test results and the inhibitor titers in hemophilia A inhibitor-positive patients. Methods: In this cross-sectional study, 41 patients with severe hemophilia A and inhibitors (and negative for lupus anticoagulant) were included from the hemophilia clinic of Shandong Blood Center from February 2022 to February 2024. All patients underwent APTT mixing test. The Rosner's index (RI, including the immediate RI and the RI after 2-hour water bath incubation [water bath 2h RI]), the time-dependent difference (Δ value), and the corrected percentage were calculated based on results of APTT mixing test. The median (interquartile range) of the corresponding indexes were calculated, and the ROC curves for identification of high inhibitor titers using the four indexes (the immediate RI, the water bath 2h RI, the Δ value, and the corrected percentage) were plotted, The correlations between APTT mixing test and inhibitor titers for coagulation factor Ⅷ (Factor Ⅷ, FⅧ) were investigated. Results: The median (lower quartile, upper quartile) of immediate RI, water bath 2h RI, Δ-value and corrected percentage for FⅧ inhibitor positive patients were 11.0 (5.4, 29.3)%, 45.0 (25.7, 75.0)%, 26.2 (7.6, 41.8) s, and 82.2 (58.5, 91.6)%, respectively. The median (lower quartile, upper quartile) of the immediate RI, water bath 2h RI, Δ-value and corrected percentage were 25.2 (13.0, 37.5)%, 64.1 (44.6, 72.6)%, 38.0 (14.3, 38.3) s, and 66.5 (50.1, 82.1)% for the high-titer inhibitor group, and 5.2 (4.2, 9.4)%, 17.9 (8.8, 28.0)%, 13.0 (7.6, 25.4) s, and 92.3 (88.0, 94.3)% for the low-titer inhibitor group. The AUCs of the ROC curves for discrimination between high and low titer inhibitor were: 0.9105 for immediate RI, 0.9118 for water bath 2h RI, 0.8873 for correcter percentage, and 0.6532 for Δ-value. Conclusion: High-titer inhibitors can be highly suspected in hemophiliac patients with an immediate RI >10% and a water bath 2h RI >45%, and the presence of low-titer inhibitors is suspected in patients with a 4-second < immediate RI <10% and a 13% < water bath 2h RI <45%.
5.Distribution of platelet antibodies and their specificity in Zhongshan area
Huiyan LIN ; Yonglun WU ; Ainong SUN ; Yuru FANG ; Qianying CHEN ; Qiao LI ; Yujue WANG ; Hongmei WANG ; Zhizhao YANG ; Xiaoyi JIAN ; Xianguo XU ; Shengbao DUAN
Chinese Journal of Blood Transfusion 2024;37(1):63-67
【Objective】 To investigate the frequency of platelet antibodies in voluntary blood donors and patients in Zhongshan, Guangdong Province, and to study the specificity and cross-matching of platelet antibodies. 【Methods】 Platelet antibodies of blood donors and patients were screened by solid-phase immunoadsorption (SPIA), rechecked by flow cytometry (FCM), and antibody specificity was identified by PakPlus enzyme immunoassay, and platelet cross-matching was simulated by SPIA. 【Results】 A total of 1 049 blood donor samples and 598 patient samples were tested, with 6 (0.57%) and 49 (8.19%) samples positive for SPIA,respectively(P<0.05); In SPIA positive samples, the positive concordance rate of FCM in blood donors and patients was 100% vs 95%, and that of enzyme immunoassay was 100% vs 88%. Among the initial screening positive samples of blood donors, 5 were anti-HLA Ⅰ antibodies, accounting for 83%, and 1 was anti CD36 antibody, accounting for 17%, with an incidence rate of 0.10%. Among the 14 samples of enzyme immunoassay positive patients, 2 were anti-GP Ⅱb/Ⅲa, 1 was anti-GP Ⅱa/Ⅱa, 8 were anti HLA Ⅰ, and 3 were mixed antibodies (HLA Ⅰ, GP Ⅱb/Ⅲa, GP Ⅰa/Ⅱa). According to the types of antibodies, HLA Ⅰ antibodies were the most common, accounting for 65% (11/17), followed by HPA related anti GP, accounting for 35% (6/17). The majority of patients had a platelet antibody positive typing rate below 30%, accounting for 71.4% (10/14). 【Conclusions】 The positive rate of platelet antibody of patients in Zhongshan area is significantly higher than that of voluntary blood donors, and most of them are anti-HLA Ⅰ and anti-GP, and the incidence of anti-CD36 is extremely low. Therefore, it is necessary to establish a known platelet antigen donor bank, and at the same time, carry out platelet antibody testing and matching of patients, which is helpful to solve the issue of platelet transfusion refractoriness.
6.Research progress in the diagnosis and control of animal Lyme disease
Jing-Zhe YU ; Jian-Qiao QIU ; Lan ZHOU ; Ren-Dong FANG ; Xue-Lei CHEN
Chinese Journal of Zoonoses 2024;40(1):62-69
Lyme disease is a natural zoonotic infectious disease transmitted by ticks infected by different genotypes of Borre-lia burgdorferi sensu lato,which was discovered in the 1970s.This pathogen is prevalent primarily in temperate and subtropi-cal areas.Dogs,cats,horses,cattle,deer,and other animals are susceptible,and humans are also susceptible hosts.The main symptoms of Lyme disease in humans are erythema migrans,arthritis,and other neurological symptoms,and the common symptoms in infected animals include joint diseases,coat shedding,fever,laminitis,and lameness.Lyme disease is wide-spread,but diagnosis is difficult,and this disease is easily misdiagnosed and missed.Awareness of Lyme disease must be in-creased to avoid its toll on livestock and the pet industry.Therefore,this article reviews research progress in diagnosis and con-trol technology for animal Lyme disease and Borrelia burgdorferi,to provide a reference for accurate,rapid diagnosis and con-trol of Lyme disease.
7.Clinical characteristics and risk analysis of novel coronavirus repeated infection
Jing DONG ; Fang LIU ; Shouang QIAO ; Shuo WANG
Journal of Chinese Physician 2024;26(2):180-184
Objective:To understand the clinical characteristics of novel coronavirus reinfection and explore the risk factors of novel coronavirus reinfection.Methods:The clinical data of 340 patients with novel coronavirus infection who were admitted to the Fever Clinic of Beijing Traditional Chinese Medicine, Capital Medical University from December 2022 to January 2023 were included. The general characteristics, basic diseases, clinical symptoms, and examination results of the first and second infections in the non repeated infection group, the repeated infection group, and the repeated infection group were compared. Binary logistic multivariate analysis was used to explore the risk factors of novel coronavirus reinfection.Results:In this study, 340 patients with novel coronavirus infection were included, 180 of whom were repeatedly infected. There was no statistically significant difference (all P>0.05) in terms of gender, age, body mass index (BMI), exercise, smoking, daily routine, and underlying disease between the recurrent infection group and the non recurrent infection group. However, the vaccination rate of the recurrent infection group was lower than that of the non recurrent infection group [80.0%(144/180) vs 88.0%(142/169), P<0.05]; In the repeated infection group, 157 cases (87.2%) were accompanied by overall discomfort (including headache, fatigue, muscle and joint pain), which was significantly higher than 122 cases (76.2%) in the non repeated infection group. The proportion of pneumonia occurring during the first infection was higher than that in the non repeated infection group [15.6%(28/180)], and the difference was statistically significant ( P<0.05). The interval between the first and second infections in the repeated infection group was (166.2±8.3)days. Cough and phlegm were the main clinical manifestations of two infections; The duration of re infection was shorter than that of the first infection [(7.03±2.30)days vs (8.94±3.02)days, t=6.739, P<0.001]; Secondary infections had less incidence of pneumonia [5.0%(9/180) vs 15.6%(28/180), χ 2=10.874, P=0.001]; 153 patients (85.0%) reported milder secondary infections. The results of binary logistic regression showed that cough, expectoration, body discomfort and pneumonia during the first infection were risk factors for repeated infection of novel coronavirus ( OR=2.710, 2.293, 2.808, P<0.05), and vaccination was a protective factor to avoid repeated infection ( OR=0.470, P=0.019). Conclusions:The symptoms of novel coronavirus reinfection are generally mild and the course of disease is relatively short. For vulnerable people, novel coronavirus vaccine should be actively inoculated to strengthen protection.
8.Study on the Distribution and Clinical Characteristics of TCM Syndromes in Infertility Patients with Autoimmune Thyroiditis
Xiaoru FANG ; Limin WU ; Qunying FANG ; Mengli WANG ; Shiyu ZHAO ; Zonghui QIAO ; Hongbing LUAN ; Zhaohui FANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):164-170
Objective To investigate the distribution and clinical characteristics of TCM syndromes in infertility patients with autoimmune thyroiditis(AIT).Methods By referring to the relevant literature on the distribution of TCM syndromes of AIT and infertility in women of childbearing age,the TCM Syndromes Survey of Infertility Patients with Autoimmune Thyroiditis was formulated.256 cases of infertility patients with AIT who underwent in vitro fertilization-embryo transfer(IVF-ET)at the Reproductive Center of The First Affiliated Hospital of University of Science and Technology of China from June 2019 to December 2020 were retrospectively analyzed.The data of basic information,TCM syndromes,basic thyroid-stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(TG-Ab)were collected.By means of frequency analysis and systematic cluster analysis,the distribution regularity of TCM syndromes in infertility patients with AIT were concluded.Results After analysis,the following 5 common syndrome elements were obtained,namely,qi deficiency,liver depression,spleen deficiency,kidney deficiency and blood stasis.In addition,it was concluded that this disease was more common in complex syndromes.Through systematic clustering analysis,main TCM syndromes of this disease were obtained,which were qi deficiency and liver depression syndrome(69 cases,26.9%),spleen and kidney deficiency syndrome(45 cases,17.6%),spleen qi deficiency syndrome(38 cases,14.8%),qi deficiency and blood stasis syndrome(36 cases,14.1%),kidney deficiency and liver depression syndrome(32 cases,12.5%)and other syndrome types(36 cases,14.1%).The basic TSH level was higher in patients with qi deficiency and liver depression syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome than other syndrome types,with statistical significance(P<0.05).There was no significant difference in TPO-Ab and TG-Ab titers among different syndromes(P>0.05).Conclusion TCM syndromes of infertility patients with AIT can be clustered into qi deficiency and liver depression syndrome,spleen and kidney deficiency syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome,kidney deficiency and liver depression syndrome and other syndrome.The main element of syndrome is qi deficiency,and the pathological sites involved spleen,kidney and liver.Stasis blood is a main pathological product.It is required to pay close attention to the thyroid function in AIT patients with qi deficiency.
9.Effect of Shegan Mahuangtang and Its Pungent and Bitter Chinese Herbs on Airway Inflammation and Expression of TRPV1/TAS2R14 in Lung Tissue of Rat Model of Cold Asthma
Yamei YUAN ; Weidong YE ; Yue CHENG ; Qiuhui LI ; Jiaxin LIU ; Jiale QIAO ; Kun WANG ; Xiangming FANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(21):1-9
ObjectiveTo investigate the effects of Shegan Mahuangtang and its pungent and bitter Chinese herbs on the expression of transient receptor potential vanilloid-1 (TRPV1) and bitter taste receptor 14 (TAS2R14) in the lung tissue of the rat model of cold asthma. MethodSeventy SD rats were randomized into 7 groups: normal, model, Shegan Mahuangtang, pungent Chinese herbs, bitter Chinese herbs (6.43 g·kg-1), dexamethasone (0.5 g·kg-1), and Guilong Kechuanning (10 g·kg-1). The rat model of cold asthma was established by intraperitoneal injection and subcutaneous injection of 10% ovalbumin (OVA) and aluminium hydroxide in the limbs, combined with 2% OVA atomization and cold (2-4 ℃) stimulation. The rats were treated with corresponding drugs by gavage and atomization, and the normal and model groups were treated with the same amount of normal saline for 3 weeks. After the last excitation, airway inflammation and cell proliferation were observed by hematoxylin-eosin (HE), periodic acid-Schiff (PAS), and Masson staining of the lung tissue. The levels of interleukin-5 (IL-5), tumor necrosis factor-α (TNF-α), thymic stromal lymphopoietin (TSLP), and transforming growth factor-β1 (TGF-β1) in the serum were measured by enzyme-linked immunosorbent assay (ELISA). The expression of TRPV1 and TAS2R14 was detected by immunofluorescence. The expression of TRPV1, TAS2R14, phospholipase Cβ2 (PLCβ2), B-cell lymphoma-2 (Bcl-2), and α-smooth muscle actin (α-SMA) in the lung tissue was determined by Western blot. ResultCompared with the normal group, the model group showed decreased water intake, food intake, and body weight, increased airway inflammatory cell infiltration, goblet cell proliferation, tissue fibrosis and collagen deposition, elevated levels of IL-5, TNF-α, TSLP, and TGF-β1 in the serum (P<0.01), upregulated expression of TRPV1, PLCβ2, and α-SMA, and downregulated expression of TAS2R14 and Bcl-2 (P<0.05, P<0.01). Compared with model group, Shecgan Mahuangtang, pungent Chinese herbs, and bitter Chinese herbs increased the water intake, food intake, and body weight, reduced the inflammatory cell infiltration and goblet cell proliferation, alleviated tissue fibrosis and collagen deposition, lowered the levels of IL-5, TNF-α, TSLP, and TGF-β1 in the serum (P<0.01), downregulated the expression of TRPV1, PLCβ2, and α-SMA, and upregulated the expression of TAS2R14 and Bcl-2 (P<0.05, P<0.01). ConclusionShegan Mahuangtang and its pungent and bitter Chinese herbs can reduce OVA-induced airway inflammation, downregulate the expression of TRPV1, PLCβ2, and α-SMA, and upregulate the expression of TAS2R14 and Bcl-2 in asthmatic rats. Moreover, bitter Chinese herbs outperformed pungent Chinese herbs, and the combination of them enhanced the therapeutic effect. It is suggested that Shegan Mahuangtang and its pungent and bitter Chinese herbs may ameliorate the OVA-induced airway inflammation by inhibiting TRPV1 and activating TAS2R14.
10.Intense pulsed light combined with meibomian gland massage in the treatment of meibomian gland dysfunction related dry eye
Fabin WANG ; Xin GOU ; Fang WU ; Hong QIAO ; Dengli ZHAO
International Eye Science 2024;24(11):1807-1810
AIM: To investigate the effect of intense pulsed light(IPL)combined with meibomian gland massage in patients with meibomian gland dysfunction(MGD)related dry eye.METHODS: Retrospectively selected 300 cases(300 right eyes)that diagnosed as MGD-related dry eye and treated in our hospital from October 2021 to October 2023, and they were divided into two groups according to the treatment modalities: 150 cases(150 eyes)in the control group were treated with meibomian gland massage, and 150 cases(150 eyes)in the observation group were treated with combined IPL. The efficacy of the two groups was compared, as well as the changes in tear film stability indexes [tear film break-up time(BUT), Schirmer I test(SIT)], ocular surface disease index(OSDI)scores, tear film lipid layer thickness(LLT), mean objective scattering index(OSI), and the levels of inflammatory factors in the tear fluid [interleukin-10(IL-10)and IL-6].RESULTS: There was a difference in efficacy between the two groups of patients after treatment(88% vs 74%, P=0.002). At 8 wk after treatment, OSDI score, OSI, and tear IL-6 levels decreased, while BUT, SIt, LLT, and tear IL-10 levels increased in the two groups, and the observation group was better than the control group(all P<0.05).CONCLUSION: IPL combined with meibomian gland massage for the treatment of dry eye patients with MGD is therapeutically effective, improving corneal stability and LLT, and reducing levels of OSI and inflammatory factors.

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