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.The two-year follow up study on the association between new caries risk in school aged children and multi dimensional sleep indicators
LU Xiuzhen, HUANG Chuanlong, LI Yang, ZUO Min, SUN Ying, CHEN Xin
Chinese Journal of School Health 2025;46(4):579-583
Objective:
To explore the prospective association between multidimensional sleep indicators and the risk of newlyonset dental caries, providing a reference for childrens oral healthrelated sleep intervention.
Methods:
In October 2021, 1 417 students in grades 1 to 4 (aged 6 to 11) from two elementary schools in Bengbu, Anhui Province, were selected by cluster sampling method. Surveys and followup visits were conducted at baseline (T1), November 2022 (T2), May 2023 (T3), and November 2023 (T4), respectively, including parental questionnaires, oral health and physical examination. Bedtime, sleep duration, sleep midpoint, social jet lag, weekend catchup sleep, and sleep habits were collected and calculated. A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newlyonset caries in schoolaged children after 2 years.
Results:
The prevalence of dental caries in children was 65.1% at baseline, and the prevalence was 59.0% at the end of the 2year followup. Cox proportional risk regression model showed that for every 1point increase in the childrens bedtime resistance, nocturnal awakenings, parasomnias, and daytime sleepiness scores, the risk of newlyonset caries increased by 12% (HR=1.12, 95%CI=1.08-1.15), 22% (HR=1.22, 95%CI=1.15-1.29), 12% (HR=1.12, 95%CI=1.08-1.17), and 15% (HR=1.15, 95%CI=1.12-1.19), respectively; the risk of newlyonset caries increased by 23% for each 1 h increase in the length of weekend catchup sleep (HR=1.23, 95%CI=1.14 -1.33); compared with children who went to bed before 21:00 on school days, those who went to bed later than 22:00 had a 57% higher risk of newlyonset caries (HR=1.57, 95%CI=1.22-2.03). Compared to children who slept adequately (≥9 h/d), those with insufficient sleep had a 67% higher risk of new caries (HR=1.67, 95%CI=1.43-1.95) (P<0.01).
Conclusions
These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries. Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance childrens oral health outcomes.
3.Association between bedroom nocturnal light exposure and objective sleep parameters in college students
ZHANG Anhui, YU Min, XU Yuxiang, SUN Ying
Chinese Journal of School Health 2025;46(8):1098-1101
Objective:
To investigate the cross sectional association between bedroom nocturnal light exposure and objectively measured sleep parameters in college students, so as to provide evidence for promoting sleep health.
Methods:
From September to October 2019, a convenience sampling method was used to recruit 365 healthy college students from two universities in Hefei, establishing a cohort. Bedroom nocturnal light exposure was measured at the individual level for two consecutive days using a portable illuminometer (TES-1339R; Taishi Corp, Taiwan, China). Sleep parameters were objectively measured over seven consecutive days using wrist worn accelerometers (ActiGraph GT3X-BT, Pensacola, FL). Multiple linear regression models were employed to examine the association between nocturnal light exposure and sleep parameters.
Results:
Compared to the low nocturnal light exposure (<3 lx) group, the high exposure (≥3 lx) group exhibited significantly lower sleep efficiency[(93.5± 2.7 )%,(92.2±2.9)%, t =3.93], longer wake after sleep onset (WASO)[(24.7±90.3)(29.2±11.2)min, t =-3.66], higher movement index(11.0±3.6, 12.2± 3.8, t =-2.80), and higher sleep fragmentation index(20.5±6.5,23.0±7.0, t =-3.24) (all P <0.01). After adjusting for covariates,multiple linear regression showed that,compared to the low nocturnal light exposure group, the high exposure group had reduced sleep efficiency ( β =-1.15, 95% CI =-1.78 to -0.52), increased WASO [ β (95% CI )=3.94(1.55- 6.33 )], higher movement index[ β (95% CI )=1.05(0.20-1.89)], and elevated sleep fragmentation index[ β (95% CI )=2.35(0.81-3.88)](all P <0.05).
Conclusions
Light exposure at night negatively impacts college students sleep. Optimizing bedroom lighting management may improve sleep quality in adolescents.
4.Association between intergenerational parent-child separation and allergic diseases among rural preschool children
ZHU Min, MA Kai, ZHANG Anhui, YU Min, WANG Yufen, SUN Ying
Chinese Journal of School Health 2025;46(9):1333-1336
Objective:
To investigate the impact of intergenerational parent-child separation (PCS) on allergic diseases among rural preschool children, providing theoretical guidance for developing targeted public health interventions.
Methods:
From March to June 2024, 10 kindergartens were selected from Nanling, Wuhu City, Anhui Province. A total of 2 279 children aged 3-6 years and their parents/primary caregivers participated in the survey by a combination of convenience sampling and cluster sampling method. Children s fathers and mothers reported the experiences of PCS during their childhood. The children s PCS experiences and allergies were reported by their primary caregivers. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to supplement the allergies (allergic asthma, allergic rhinitis and atopic dermatitis). Analysis of variance (ANOVA) and Chi square tests were used to compare differences between children in different PCS groups. Logistic regression models assessed the association between PCS and the risk of allergic diseases in preschool children.
Results:
Among the preschoolers enrolled, the prevalence of allergic diseases in only parent-child separation group in childhood, only child separation group, and the intergenerational continuity of PCS groups were significantly higher than those of the none separation group (38.0%, 41.8%, 48.1%,30.4%; χ 2=40.45, P < 0.01 ). After adjusting for covariates including child age, sex and body mass index, Logistic regression model revealed that compared to children in the group without PCS, those in the only parent-child separation in childhood( OR =1.43, 95% CI =1.06-1.94), only child separation ( OR =1.82, 95% CI =1.22-2.71), and intergenerational continuity of PCS ( OR =2.33, 95% CI =1.68-3.24) exhibited higher allergic disease risk (all P <0.05).
Conclusions
Intergenerational continuity of PCS is related to the increased risk of allergies in preschool children. The multigenerational accumulation of adverse effects from PCS underscores the importance of breaking the cycle of disadvantage across generations.
5.Follow up study of the association between bedroom light at night exposure and body mass index in children
LI Qi, ZHOU Yi, DING Wenqin, ZUO Min, XU Yuxiang, TAO Fangbiao, SUN Ying
Chinese Journal of School Health 2024;45(4):475-478
Objective:
To explore the association between bedroom light at night (LAN) exposure and body mass index (BMI) in children at 1 year follow up, so as to provide new strategies for obesity prevention.
Methods:
From December 2021 to May 2022, cluster random sampling was conducted, involving 648 children from two primary schools in Tianchang, Chuzhou City, Anhui Province, China, to assess bedroom LAN exposure of children during sleep. A questionnaire survey and physical examination were carried out in May 2022. Multivariate linear regression was performed to analyze the correlation between bedroom LAN exposure and BMI variable quantity at 1 year follow up (May, 2023).
Results:
The median intensity of bedroom LAN exposure during the sleep episode was [1.11(0.35,3.24)lx] in children. The proportion of the sample exposed to an average light intensity of ≥3 lx was 27.5%, while 19.0% was exposed to a LAN intensity of ≥5 lx during the sleep episode. In the multivariable linear regression, after adjusting for covariates, including sex, baseline age, sleep duration, family monthly income, and maternal education level, exposure to a 1 h-average post bedtime LAN intensity of ≥3 lx ( β=0.25, 95%CI =0.05-0.44) and LAN≥5 lx ( β=0.34, 95% CI = 0.12-0.55) was associated with a gain of 0.25 and 0.34 kg/m 2, respectively, in the children s BMI at the 1 year follow up ( P < 0.05).
Conclusions
A positive correlation was found between bedroom LAN exposure and BMI variable quantity at 1 year follow up in children. Thus, reduced bedroom LAN exposure might be useful for interventions aimed at obesity prevention.
6.Identification of TEAD1 Transcripts and Functional Analysis in Chicken Preadipocytes
Min PENG ; Hu XU ; Zi-Qiu JIA ; Qing-Zhu YANG ; Lin PAN ; Wei-Yu WANG ; Ling-Zhe KONG ; Ying-Ning SUN
Progress in Biochemistry and Biophysics 2024;51(1):215-229
ObjectiveAlthough expression of the TEAD1 protein in preadipocytes has been established, its function remains unclear. In this study, we sought to detect transcripts of TEAD1 in chicken and to examine the effects of this protein on the proliferation, migration, apoptosis, and differentiation of immortalized chicken preadipocyte cell lines (ICP1). MethodsThe full-length sequence of the TEAD1 gene was cloned and the two transcripts were subjected to bioinformatics analysis. The subcellsular localization of TEAD1 transcripts was determined based on indirect immunofluorescence. The effects of TEAD1 transcripts overexpression on the proliferation of ICP1 cells were examined by RT-qPCR, CCK-8, and EdU assays; the effects of TEAD1 transcripts on ICP1 cells migration were examined based on the scratch test; and the effects of TEAD1 transcripts overexpression on ICP1 cells apoptosis were analyzed using apoptosis-Hoechst staining and RT-qPCR. The expression of TEAD1 transcripts in different tissues, cells lines, and ICP1 at different periods of differentiation was analyzed by RT-qPCR. The effects of TEAD1 transcripts overexpression on lipid droplet accumulation and adipogenic-related gene expression in ICP1 cells were analyzed based on Oil Red O and BODIPY staining, RT-qPCR, Western blot, and dual-luciferase reporter gene assays. Finally, the content of triglyceride (TG) was measured in TEAD1 overexpressed ICP1 cells. ResultsThe full-length TEAD1 was cloned and two TEAD1 transcripts were identified. The TEAD1-V1 protein was found to be localized primarily in the cell nucleus, whereas the TEAD1-V2 protein is localized in the cell cytoplasm and nucleus. The overexpression of both TEAD1-V1 and TEAD1-V2 significantly inhibited the proliferation of ICP1 cells. Whereas the overexpression of TEAD1-V1 promoted ICP1 cell migration, the overexpression of TEAD1-V2 had no significant effects on ICP1 migration; the overexpression of both TEAD1-V1 and TEAD1-V2 significantly promoted the apoptosis of ICP1 cells. We found that the different transcripts of TEAD1 have similar expression pattern in different tissues and cells lines. During induced preadipocyte differentiation, the expression of these genes initially declined, although subsequently increased. Overexpression of TEAD1-V1 promoted a significant reduction in lipid droplet formation and inhibited C/EBPα expression during the differentiation of ICP1 cells (P<0.05). However, the overexpression of TEAD1-V2 had no significant effect on lipid droplet accumulation or the expression of adipogenic-related proteins (P>0.05). Overexpression of TEAD1-V1 significantly decreased triglyceride content in ICP1 cells (P<0.05), while overexpression of TEAD1-V2 had no effect on triglyceride content in ICP1 cells (P>0.05). ConclusionIn this study, for the first time, identified two TEAD1 transcripts. Overexpressed transcripts TEAD1-V1 and TEAD1-V2 both inhibited the proliferation of chicken preadipocytes and promoted apoptosis of chicken preadipocytes. TEAD1-V1 inhibited the differentiation of preadipocytes and promoted the migration of preadipocytes, while TEAD1-V2 had no effect on the differentiation and migration of preadipocytes.
7.Effect of Mahuang Xixin Fuzitang on Migration of Dendritic Cells in Mice by Regulating Rho/ROCK Signaling Pathway
Shuyue FAN ; Luwei WU ; Tongtong SUN ; Yuying NI ; Jing GAO ; Ying CUI ; Min LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):35-42
ObjectiveTo investigate the inhibitory effect of Mahuang Xixin Fuzitang on the migration of dendritic cells (DCs) in mice and its underlying mechanism. MethodMouse bone marrow-derived DCs were isolated and cultured. The morphological changes of the cells at different stages were observed under a microscope, and the CD11c+ proportion was detected by flow cytometry to identify DC purity. Cells were treated with Mahuang Xixin Fuzitang (1, 2, 5, 10, 20, 40, 50, 100 g·L-1) for 24 hours, and the effect of Mahuang Xixin Fuzitang on cell proliferation was assessed using the cell counting kit-8 (CCK-8) assay to determine the appropriate concentrations for treatment. After modeling by lipopolysaccharide (LPS) induction, DCs were divided into a blank group, a model group, and Mahuang Xixin Fuzitang groups (2, 4, 8 g·L-1). The expression of surface molecules CD80, CD86, and major histocompatibility complex-Ⅱ (MHC-Ⅱ) were detected by flow cytometry. Transwell chamber assay was used to observe cell migration. The levels of chemokine C-C-primitive receptor 7 (CCR7) and chemokine C-X-C-primitive receptor 4 (CXCR4) on the cell surface were detected by enzyme-linked immunosorbent assay (ELISA). The expression of filamentous actin (F-actin) in the cell microfilament cytoskeleton was detected by immunofluorescence (IF) staining. Real-time quantitative polymerase chain reaction (Real-time PCR) was employed to determine the mRNA expression levels of Ras homolog family member A (RhoA) and Rho-associated coiled-coil containing protein kinase 1 (ROCK1). Western blot analysis was performed to detect the protein expression of RhoA and ROCK1. ResultCompared with the blank group, the model group exhibited significantly higher expression levels of CD80, CD86, and MHC-Ⅱ (P<0.01), a significantly increased number of cells migrating to the lower chamber (P<0.01), and significantly elevated levels of CCR7 and CXCR4 (P<0.05, P<0.01). Additionally, F-actin expression was significantly increased (P<0.01), and both RhoA and ROCK1 mRNA and protein expression levels were significantly higher (P<0.05, P<0.01). Compared with the model group, treatment with Mahuang Xixin Fuzitang (2, 4, 8 g·L-1) for 24 hours resulted in significantly lower expression levels of CD80, CD86, and MHC-Ⅱ (P<0.01), a significantly reduced number of cells migrating to the lower chamber (P<0.05), and significantly decreased levels of CCR7 and CXCR4 (P<0.05, P<0.01). Furthermore, F-actin expression was significantly reduced (P<0.01), and both RhoA and ROCK1 mRNA and protein expression levels were significantly decreased (P<0.05, P<0.01). ConclusionMahuang Xixin Fuzitang can inhibit the migration of DCs in mice, and its mechanism of action may be related to reducing the activity of the Rho/ROCK signaling pathway, thereby affecting changes in the cell cytoskeleton.
8.Improvement of creating pharmaceutical science popularization with internet medication consultation as orientation
Min SUN ; Benru XIN ; Ying LI ; Xiaoyan QI ; Jianfang LIU ; Li XU
China Pharmacy 2024;35(17):2142-2146
OBJECTIVE To explore the new idea of creating pharmaceutical science popularization oriented by internet medication consultation questions, and provide references for pharmacists to create high-quality pharmaceutical science popularization articles. METHODS By taking the internet medication consultation questions from September 1st, 2021 to February 28th, 2022 in a hospital as samples, pharmaceutical science popularization were created by using the Pareto chart for summarizing and analyzing the demands of the public pharmaceutical knowledge. The readers and creating cycle of pharmaceutical science popularization before and after the implementation of this method were compared by statistical analysis. RESULTS According to the Pareto principle, the types of consultation questions were mainly concentrated on usage and dosage, adverse reactions, and precautions; the types of drug consultation were mainly concentrated on respiratory system medications, anti-infective drugs, rheumatic immune system medications, and orthopedic medications, etc. Fifteen topics of science popularization were identified. Among them, 5 were published before 2022 and did not adopt the Pareto chart method, serving as the pre-method and consistent with the target theme group (A group); 10 were published in 2022 after adopting the Pareto chart method, serving as the post- method group (B group); 5 articles published before 2022 were selected randomly, without adopting the Pareto chart method and inconsistent with the target theme, serving as the pre-method and inconsistencies with the target theme group (C group). Compared with the A group and the C group, the creating cycle of pharmaceutical science popularization in the B group was significantly reduced. Compared with the C group, the readers were significantly increased in the A group and the B group. CONCLUSIONS Pareto chart could help pharmacists utilize medication consultation questions to identify the pharmaceutical science popularization needed by the public, which could improve the efficiency and quality of creating pharmaceutical science popularization by pharmacists.
9.Clinical characteristics and management status of Turner syndrome in 1 089 children
Yan LIANG ; Haiyan WEI ; Ruimin CHEN ; Zhixin ZHANG ; Xinran CHENG ; Na TAO ; Chunlin WANG ; Yu YANG ; Ying XIN ; Xin FAN ; Xingxing ZHANG ; Geli LIU ; Shengquan CHENG ; Min ZHU ; Hongwei DU ; Yan SUN ; Linqi CHEN ; Lanwei CUI ; Xiaoping LUO
Chinese Journal of Pediatrics 2024;62(10):962-968
Objective:To investigate the clinical characteristics and management status of children with Turner syndrome (TS) in China.Methods:As a cross-sectional study, 1 089 TS patients were included in the database of the National Collaborative Alliance for the Diagnosis and Treatment of Turner Syndrome from August 2019 to November 2023. Clinical characteristics (growth development, sexual development, organ anomalies, etc.), karyotypes, auxiliary examinations, and treatments were collected and analyzed.Results:Among the 1 089 TS cases, 809 were recorded karyotypes. The karyotype distribution was as follows: 45, X in 317 cases (39.2%), X chromosome structural variants (including partial deletions of p or q arm, ring chromosome, and marker chromosome) in 89 cases (11.0%), 45, X/46, XX mosaicism in 158 cases (19.5%), mosaicism with X chromosome structural variants in 209 cases (25.8%), and presence of Y chromosome material in 36 cases (4.4%). Among the 824 TS cases, the age of diagnosis was 9.7(6.4, 12.2) years, with a height standard deviation score (HtSDS) of -3.1±1.2. Five hundred and fifty three cases underwent growth hormone (GH) stimulation test, and 352 cases (63.7%) had GH peak values <10 μg/L and 75.9% (577/760) had low IGF1 levels, with IGF1 SDS ≤-2 accounting for 38.2% (290 cases). Among 471 cases aged ≥8 years, 132 cases (28.0%) showed spontaneous sexual development (mean bone age (11.0±1.7) years), 10 cases had spontaneous menarche (mean bone age (12.0±2.2) years), and 2 cases had regular menstrual cycles. Common physical features included cubitus valgus (311 cases (28.5%)), neck webbing (188 cases (17.2%)), low posterior hairline (185 cases (17.0%)), shield chest (153 cases (14.0%)), high arched palate (127 cases (11.6%)), short fourth metacarpal (43 cases (3.9%)), and spinal abnormalities (38 cases (3.5%)). Congenital cardiovascular and urogenital anomalies occurred in 91 cases (19.4%) and 66 cases (12.0%)respectively. Abdominal ultrasound in 33 cases (7.2%) indicated fatty liver, hepatomegaly, intrahepatic bile duct stones, and splenomegaly. Among 23 cases undergoing oral glucose tolerance test (OGTT) test, 2 were diagnosed with diabetes mellitus and 4 with impaired glucose tolerance. Following diagnosis, 669 cases (80.7%) received rhGH treatment at a chronological age of (9±4) years and bone age of (8.3±3.2) years. Additionally, 112 cases (19.4%) received sex hormone replacement therapy starting at the age of (14±4) years and bone age of (12.6±1.2) years.Conclusions:The karyotypes of 45, X and mosaicism were most common in Chinese children with TS. The clinical manifestations were mainly short stature and gonadal dysplasia. However, a few TS children could be in the normal range of height, and some cases among those aged of ≥8 years old had spontaneous sexual development. Some exhibited physical features, congenital cardiovascular and urogenital anomalies, and dysfunction of the hypothalamic-pituitary-IGF1 axis. Moreover, a few of them developed impaired glucose tolerance and diabetes mellitus. Following diagnosis, most of the patients received rhGH treatment, and a few of them received sex hormone replacement therapy.
10.Clinical trial of Morinda officinalis oligosaccharides in the continuation treatment of adults with mild and moderate depression
Shu-Zhe ZHOU ; Zu-Cheng HAN ; Xiu-Zhen WANG ; Yan-Qing CHEN ; Ya-Ling HU ; Xue-Qin YU ; Bin-Hong WANG ; Guo-Zhen FAN ; Hong SANG ; Ying HAI ; Zhi-Jie JIA ; Zhan-Min WANG ; Yan WEI ; Jian-Guo ZHU ; Xue-Qin SONG ; Zhi-Dong LIU ; Li KUANG ; Hong-Ming WANG ; Feng TIAN ; Yu-Xin LI ; Ling ZHANG ; Hai LIN ; Bin WU ; Chao-Ying WANG ; Chang LIU ; Jia-Fan SUN ; Shao-Xiao YAN ; Jun LIU ; Shou-Fu XIE ; Mao-Sheng FANG ; Wei-Feng MI ; Hong-Yan ZHANG
The Chinese Journal of Clinical Pharmacology 2024;40(6):815-819
Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P<0.05).After continuation treatment,the remission rate was 54.59%(202 cases/370 cases),and the recurrence rate was 6.49%(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35%(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.


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