1.Intervention of Traditional Chinese Medicine in Diabetic Nephropathy by Regulating Nrf2 Signaling Pathway: A Review
Qinyuan ZHANG ; Yanxu CHEN ; Dakai QIN ; Jin PENG ; Zhisheng JIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):277-285
Diabetic nephropathy (DN) is a serious chronic microvascular complication of diabetes mellitus (DM) and a major cause of end-stage renal disease (ESRD). It is characterized by gradual and progressive decline of renal function, which eventually leads to glomerular sclerosis, interstitial fibrosis and other serious lesions. Although modern medical treatment can partially relieve the symptoms, there are limitations such as single therapeutic effect, low long-term therapeutic effect, and severe side effects. Traditional Chinese medicine (TCM), with a wide effect range, lasting efficacy, and high safety, often exerts unique therapeutic effect in the clinical treatment of DN. Nuclear factor E2-related factor 2 (Nrf2), an anti-oxidative stress transcription factor, has received much attention. It can regulate multiple upstream and downstream factors such as heme oxygenase-1 (HO-1), NAD(P)H: quinone oxidoreductase 1 (NQO1), nuclear factor-κB (NF-κB), NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome, glutathione peroxidase 4(GPX4), and p62, playing a role in cell protection by intervening in different mechanisms. A large number of studies have found that TCM active ingredients and compound prescriptions can inhibit oxidative stress, inflammation, pyroptosis, apoptosis, and ferroptosis or promote autophagy by regulating the signaling pathway composed of Nrf2 and the above-mentioned related factors, thus protecting the kidney function, reducing proteinuria, alleviating kidney fibrosis, and significantly ameliorating DN. This review briefly summarized the structure and function of Nrf2, clarified the regulation mechanism of Nrf2 in DN, focused on the main studies on the intervention of DN by the effective components and compound formulas of TCM through the targeted activation of the Nrf2 signaling pathway in the past five years, and discussed the huge potential of Nrf2 signaling pathway as a target for the treatment of DN. The aim is to provide reference for the development and promotion of new drugs in clinical practice and promote the innovation and development of the treatment methods for DN in the future.
2.Effect of Ferroptosis on Diabetes Mellitus and Its Complications and Intervention of Chinese Medicine: A Review
Qinyuan ZHANG ; Zhisheng JIN ; Xiaoxue JIANG ; Yanxu CHEN ; Boling ZHANG ; Yaoqin FU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):280-288
Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by absolute or relative insufficiency of insulin secretion. As the disease progresses, patients begin to suffer from diabetic nephropathy, diabetic cardiomyopathy, non-alcoholic fatty liver disease or other complications, which increase the burden on the patients. Moreover, the number of patients is increasing, which brings a heavy burden to the society. Ferroptosis is a new type of programmed cell death which has attracted wide attention in recent years. It refers to the cell death caused by the excessive accumulation of lipid peroxide under the overload of iron ions. Studies have discovered that ferroptosis exists in diabetes mellitus and its complications. Inhibiting ferroptosis can greatly slow down the occurrence and progression of diabetes mellitus and its complications. Chinese medicine, the unique medical treasure in China, acts in a multi-pathway, multi-target manner and is praised for the cheap price, low toxicity, and mild side effects. It has been widely used in the treatment of diabetes mellitus and its complications and has demonstrated definite therapeutic effects, bringing the good news for the majority of patients. The regulation of ferroptosis by Chinese medicine may be a new direction for the treatment of diabetes mellitus and its complications in the future. This paper briefly describes the mechanism of ferroptosis, explores the relationship of ferroptosis with diabetes mellitus and its complications, summarizes the research status of Chinese medicine interventions, and puts forward suggestions, aiming to provide a reference for further research on the treatment of diabetes mellitus and its complications with Chinese medicine.
3.Role of Iron-lipid Disorder in Nonalcoholic Fatty Liver Disease and Research Progress of Traditional Chinese Medicine Intervention: A Review
Yanxu CHEN ; Lei ZHANG ; Zhisheng JIN ; Qinyuan ZHANG ; Xiaoxue JIANG ; Changqing XU ; Pengcheng DOU ; Cong SUN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):281-290
Nonalcoholic fatty liver disease (NAFLD) is one of the most common complications of type 2 diabetes mellitus (T2DM). Cell death caused by iron-lipid disorder is a new mode of regulating programmed cell death, which is characterized by lipid peroxidation induced by the accumulation of lipid reactive oxygen species and excessive accumulation of iron ions induced by iron metabolism disorders. Among them, iron homeostasis disorder and metabolic pathway disorder are the main causes of iron-lipid disorder, which play an important role in a variety of pathological processes related to cell death. Because the liver is an important organ for iron storage and lipid metabolism, iron-lipid disorder is an ideal target for liver disease, and inhibition of iron-lipid disorder may become a new strategy for the treatment of NAFLD. However, the pathogenic relationship and mechanism between NAFLD and iron-lipid disorder have not been fully elucidated. Based on the complex molecular regulation mechanism of iron-lipid disorder, by expounding the role of iron-lipid disorder in NAFLD and its related mechanism, this paper summarizes the research status of traditional Chinese medicine on the target treatment of NAFLD in recent years, so as to provide a new perspective and point out a new direction for the treatment of NAFLD in the future.
4.A Standardized Approach to Recommending Diagnostic Criteria in Chinese Clinical Practice Guidelines
Qi ZHOU ; Qinyuan LI ; Hongfeng HE ; Dongrui PENG ; Huayu ZHANG ; Ye WANG ; Kehu YANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1432-1438
Diagnostic criteria, as a critical component of clinical practice guidelines, play a direct role in guiding clinicians' diagnostic and treatment decisions. Although China has increasingly emphasized the development and updating of clinical guidelines in recent years, research focusing on the diagnostic criteria within these guidelines remains limited. This paper aims to explore the types of diagnostic criteria, the issues they present, and the processes involved in their formulation. Based on this analysis, suggestions are proposed to improve the recommendation and application of diagnostic criteria in Chinese guidelines.
5.A Standardized Approach to Recommending Diagnostic Criteria in Chinese Clinical Practice Guidelines
Qi ZHOU ; Qinyuan LI ; Hongfeng HE ; Dongrui PENG ; Huayu ZHANG ; Ye WANG ; Kehu YANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1432-1438
Diagnostic criteria, as a critical component of clinical practice guidelines, play a direct role in guiding clinicians' diagnostic and treatment decisions. Although China has increasingly emphasized the development and updating of clinical guidelines in recent years, research focusing on the diagnostic criteria within these guidelines remains limited. This paper aims to explore the types of diagnostic criteria, the issues they present, and the processes involved in their formulation. Based on this analysis, suggestions are proposed to improve the recommendation and application of diagnostic criteria in Chinese guidelines.
6.Analysis of serum allergen-specific immunoglobulin E in 3 051 patients with eczema or dermatitis in an allergy clinic
Fanping YANG ; Li MA ; Sheng′an CHEN ; Zihua CHEN ; Lanting WANG ; Zhen ZHANG ; Ying ZHAO ; Qinyuan ZHU ; Yu XU ; Lin TANG ; Yao HU ; Xiaoqun LUO
Chinese Journal of Dermatology 2023;56(2):136-141
Objective:To analyze measurement results of serum allergen-specific immunoglobulin E (IgE) in patients with eczema/dermatitis.Methods:A retrospective analysis was conducted on serum allergen-specific immunoglobulin E (IgE) levels in 3 051 patients with eczema/dermatitis, who visited the allergy clinic of Huashan Hospital from April 1, 2021 to March 31, 2022. The serum allergen-specific IgE level was detected by using the Phadia allergen detection system, and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis. Comparisons of enumeration data between groups were performed by chi-square test.Results:Among the 3 051 patients with eczema/dermatitis, there were 1 412 with atopic dermatitis and 1 639 were other eczema/dermatitis. Detection of serum allergen-specific IgE showed that 1 629 (53%) patients were positive for allergens, and the number of positive allergen-specific IgEs in each patient was 3.0 ± 1.6. The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae (904/1 522, 59%) , Dermatophagoides pteronyssinus (891/1 513, 59%) and Alternaria alternata (206/1 068, 19%) , and the top 3 common food allergens were shrimps (251/1 432, 18%) , egg white (165/992, 17%) and cow milk (149/994, 15%) . Among the 3 051 patients, 25 (1%) were aged < 2 years, 571 (19%) aged 2 - 12 years, 285 (9%) aged 12 - 18 years, and 2 170 (71%) were aged > 18 years. The most common food allergens were both egg white in the age groups of < 2 years and 2 -12 years (77%, 37%, respectively) , and were both shrimps in the age groups of 12 - 18 years and > 18 years (31%, 17%, respectively) . Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups, with the positive rate ranging from 36% to 84%; in addition, the positive rate of molds was relatively high in the age group of 2 - 12 years (mold mixture: 37%; Alternaria alternata: 27%) . From April 2021 to March 2022, the positive rate of outdoor allergens ranged from 10% to 15% among outpatients in every month; the positive rates of tree pollen and grass pollen increased from April 2021, and peaked in October 2021. The patients with atopic dermatitis showed a significantly increased positive rate of allergens (73%) compared with those with other eczema/dermatitis (37%, χ2 = 389.36, P<0.001) , and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis. Conclusions:The common allergens were Dermatophagoides farina, Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis. Food allergy was more common in infant patients, and inhalation allergy was more common in child, adolescent and adult patients. The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.
7.Mechanism of Hedysari Radix Polysaccharide on Diabetic Nephropathy in db/db Mice Based on JAK2/STAT3 Signaling Pathway
Yanxu CHEN ; Zhisheng JIN ; Xiaoxue JIANG ; Boling ZHANG ; Yaoqin FU ; Caiyun JIN ; Qinyuan ZHANG ; Changqing XU
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(13):65-71
ObjectiveTo observe the effect of Hedysari Radix polysaccharide (HRP) on the Janus kinase 2 (JAK2)/signal transducer and activator of transcription protein 3 (STAT3) signaling pathway in diabetic nephropathy db/db mice. MethodFifty db/db mice were randomly divided into model group, irbesartan group (irbesartan suspension, 22.75 mg·kg-1), and high-, medium-, and low-dose HRP groups (HRP suspension, 200, 100, 50 mg·kg-1) according to the body weight, with 10 mice in each group. Another 10 C57BL/6 mice were assigned to the normal group. The mice were treated with corresponding drugs by gavage, while those in the normal group and the model group received distilled water at 5 mL·kg-1. The mice in the six groups were administered once a day by gavage for 12 consecutive weeks. The uric acid (UA), triglycerides (TG), and total cholesterol (TC) were detected. Periodic acid-Schiff (PAS) staining and Masson staining were used to observe the pathological changes in kidney tissues. Western blot and Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) were used to detect the protein and mRNA expression levels of JAK2, STAT3, suppressor of cytokine signaling 3 (SOCS3), and tumor necrosis factor-α (TNF-α) in the kidney. ResultAfter 12 weeks of treatment, compared with the normal group, the model group showed significant pathological ultrastructural changes in kidney tissues and increased UA, TG, and TC levels (P<0.01). Compared with the model group, the high- and medium-dose HRP groups and the irbesartan group showed improvement in pathological ultrastructure of kidney tissues and reduced UA, TG, and TC levels (P<0.05, P<0.01). Compared with the normal group, the model group showed a decrease in SOCS3 protein and mRNA expression levels and an increase in JAK2, STAT3, and TNF-α protein and mRNA expression levels (P<0.01). Compared with the model group, the high- and medium-dose HRP groups and the irbesartan group showed an increase in SOCS3 protein and mRNA expression levels and a decrease in JAK2, STAT3, and TNF-α protein and mRNA expression levels (P<0.05, P<0.01). ConclusionHRP can alleviate renal damage in diabetic nephropathy to a certain extent, and its mechanism may be related to the inhibition of the activation of the JAK2/STAT3 signaling pathway.
8.Study on the correlation between male serum calcitonin gene-related peptide and the embryo culture outcome after in vitro fertilization
Jiajing CHEN ; Jianfeng CHEN ; Jiali CHEN ; Shuxian CHEN ; Zhiren LIU ; Qinyuan YOU ; Cuilan ZHANG ; Qicai LIU
Chinese Journal of Laboratory Medicine 2022;45(5):439-443
Objective:To investigate the correlation between serum calcitonin gene-related peptide (CGRP) and the culture outcome of in vitro fertilization embryo in male patients with infertility.Methods:In this study, the randomized samples from 25 male patients who received in vitro fertilization-embryo transfer (IVF-ET) in the 1st Affiliated Hospital of Fujian Medical University from June 2019 to October 2019 were analyzed by multiple linear stepwise regression, with some important clinical outcomes, such as the logarithmic conversion index of serum CGRP, fertilization method, masturbation difficulty, age, infertility duration, and prolactin, as independent variables, while total fertilization rate, normal fertilization rate, high quality embryo rate at day 3, blastocyst formation rate as dependent variables.Results:The Pearson correlation analysis showed that the D3 high-quality embryo rate was related to the normal sperm morphology rate in the primary infertility group ( r=0.537, P=0.048), the blastocyst formation rate was correlated with sperm density ( r=0.760, P=0.002), the CGRP logarithm was correlated with the total fertilization rate ( r=0.693, P=0.006). The logarithmic conversion index of serum CGRP was related to the total fertilization rate and normal fertilization rate in the secondary infertility group ( r=0.614, P=0.042 and r=0.611, P=0.046). In the secondary infertility group, there was a linear relationship between normal fertilization rate and total sperm count, serum CGRP log conversion, and sperm normal morphology rate, with standardized regression coefficients of 0.2, -0.729, and 6.8, respectively. Conclusion:Serum CGRP level, together with total sperm count and normal sperm morphology rate may affects normal fertilization rate in male patients with infertility.
9.Study on the Photoelectric Performance Indicators of Medical Electronic Endoscope.
Qinyuan ZHANG ; Qinglai YAN ; Xiaohang JIA ; Debao CHEN
Chinese Journal of Medical Instrumentation 2018;42(6):449-452
OBJECTIVE:
To establish a method for measuring the photoelectric performance index (luminance response characteristic and luminance tolerance) of medical electronic endoscope.
METHODS:
Based on the clinical application and product features of medical electronic endoscope, the umbrella grayscale test chart and the adjustable gray scale test chart are designed and made from two aspects of distribution and density differential.
RESULTS:
The influence of gray scale arrangement, background illumination intensity and illumination spectrum on photoelectric performance measurement of electronic endoscope is verified by test.
CONCLUSIONS
It is a reference for the design analysis, evaluation and modification of electronic endoscope product photoelectric part, whether it is suitable for fast detection of umbels and more accurate gray scale test chart.
Electronics, Medical
;
Endoscopes
;
Light
;
Quality Control
10.Epidemiological study on clinical characteristics of syndrome types of laryngeal cough based on the holism concept of TCM
Mian ZHANG ; Xiao CHEN ; Zhuoyan HUANG ; Yang GAO ; Yi LI ; Shaoyi MO ; Yong XIE ; Qinyuan ZHENG
The Journal of Practical Medicine 2017;33(18):3131-3135
Objective To study the clinical characteristics of syndrome types of laryngeal cough ,in order to provide an epidemiology basis for classification diagnosis. Methods Medical history,clinical signs and symp-toms of patients with laryngeal cough were collected. And questionnaire survey was carried out. Results (1)Of the 4 syndrome types,compared with wind evil invading lung type laryngeal cough incidence,the insecure defen-sive exterior and intrinsic special type showed no statistical difference(P>0.05). And the comparative differences between the rest 2 groups are of statistical differences(P < 0.05).(2)The onset time was analyzed. The results show laryngeal cough incidence from yin deficiency type and fire hyperactivity type showed no statistical difference (P > 0.05). The rest are all of statistical difference(P < 0.05).(3)The clinical course was analyzed. No differ-ence was found between spleen deficient phlegm type ,yin deficiency and fire hyperactivity type laryngeal cough (P>0.05). Differences of the rest 2 groups showed statistical difference(P<0.05).(4)The state of illness was analyzed. The results showed statistical difference between spleen phlegm type and yin deficiency and fire hyperac-tivity type(P<0.05). No statistical difference can be found between the rest 2 groups(P>0.05).(5)The cross-tab chi-square test was carried out on the 4 groups of syndromes on the nasal allergy eye and allergy concomitant incidence. The results showed that there was no significant difference between the 4 groups(P>0.05).(6)On the phlegm part,the results showed difference between wind evil invading lung type and yin deficiency and fire hyper- activity type laryngeal cough(P>0.05). Differences between the rest 2 groups are of statistical significance(P<0.05).(7)Foreign body sensation was analyzed. The results showed no difference between insecure defensive exte-rior and intrinsic special type and wind evil invading lung type ,deficient spleen phlegm type and yin deficiency and fire hyperactivity type(P>0.05). Differences between the rest 2 groups are all of statistical significance(P<0.05). Conclusions The 4 groups of syndrome types,insecure defensive exterior and intrinsic special type and wind evil invading lung type are the most common. Deficient spleen phlegm type is middle ,yin deficiency and fire hyperactivity type come next. Cough caused by wind invading lung mainly occurs in the evening. Its duration is usually within 1 month. It may be accompanied by phlegm with or without occasional pharyngeal paraesthesia. The daily life is usually unaffected or slightly affected. Cough caused by deficiency of vital energy and specific intrinsic quality mainly occurs in the morning. Its duration is usually 3 months to 1 year. It may be accompanied by less phlegm or no phlegm without or with occasional pharyngeal paraesthesia. The daily life is unaffected or slightly affected. Cough caused by Yin deficiency and fire hyperactivity occurs from time to time. It duration is more than 1 year. It may be accompanied by phlegm with pharyngeal paraesthesia. The daily life is unaffected or seriously affected. Cough caused by spleen deficiency and phlegm turbidity mainly occurs in the morning. Its duration is more than 1 year. It may be accompanied by more phlegm with pharyngeal paraesthesia. The daily life is seriously affected.

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