1.Textual Research on Key Information and Modern Clinical Application of Classical Famous Formula Liumotang
Xinyu ZHANG ; Chong LI ; Yixuan HU ; Luming LIANG ; Ye ZHAO ; Xiaoting LU ; Yu WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):201-212
Liumotang comes from the Yuan dynasty's Effective Prescription Handed Down for Generations of Physicians. It is composed of six medicinal materials: Arecae Semen, Aquilariae Lignum Resinatum, Aucklandiae Radix, Linderae Radix, Rhei Radix et Rhizoma, and Aurantii Fructus. It is a classical formula for treating abdominal pain due to Qi stagnation and constipation accompanied by heat. This study systematically collated the records of Liumotang in ancient medical books and modern clinical literature and conducted in-depth analysis and textual research on its formula source, main diseases, composition, dosage, medical books, container capacity, processing, preparation method, usage, drug basis, formula meaning, and other key information, so as to provide a powerful reference for the development and clinical application of compound preparations of the classical formula Liumotang. The results show that Liumotang was first seen in Effective Prescription Handed Down for Generations of Physicians, and many medical books of the past dynasties have imitated this. In terms of drug basis, the dried and mature seeds of the palm plant Areca catechu, resin-containing wood of the Daphneaceae plant Aquilaria sinensis, the dried roots of the Asteraceae plant woody Aucklandia lappa, the dried tuber root of the Lauraceae plant Lindera aggregata, the dried roots and rhizomes of the knotweed plant, R. palmatum, R.tangutikum, and R. officinale, and the dried and unripe fruits of the citrus genus C. aurantium and its cultivated varieties from the family Rutaceae were selected. In terms of dosage, through the textual research on bowls in the Ming and Qing dynasties, combined with the conversion of medicines and bowl capacity in the Qing dynasty, it was estimated that the dosage of each drug in the Yuan dynasty was 10.86 g. In the Ming and Qing dynasties, the dosage of drugs was mostly equal, but the dosage of drugs was somewhat different. In terms of processing, preparation method, and usage, in the medical books of the past dynasties, the processing of drugs has slightly changed, but raw drugs are used in all preparations. The preparation method and usage did not change much during the Yuan, Ming, and Qing dynasties, except for certain differences in dosage. In terms of syndrome, Liumotang was first used to treat abdominal pain due to Qi stagnation and constipation accompanied by heat. Medical books of the past dynasties often omit the symptoms of heat. In modern clinical practice, Liumotang is mainly used in the digestive system and urinary system diseases and is mostly used to treat constipation-predominant irritable bowel syndrome, biliary reflux gastritis, functional constipation, slow transit constipation, and other diseases, with no adverse reactions found yet. The above results provide a reliable scientific basis for the development and clinical treatment of Liumotang compound preparations.
2.Development of a nomogram-based risk prediction model for chronic obstructive pulmonary disease incidence in community-dwelling population aged 40 years and above in Shanghai
Yixuan ZHANG ; Yiling WU ; Jinxin ZANG ; Xuyan SU ; Xin YIN ; Jing LI ; Wei LUO ; Minjun YU ; Wei WANG ; Qi ZHAO ; Qin WANG ; Genming ZHAO ; Yonggen JIANG ; Na WANG
Shanghai Journal of Preventive Medicine 2025;37(8):669-675
ObjectiveTo develop a nomogram-based risk prediction model for chronic obstructive pulmonary disease (COPD) incidence among the community-dwelling population aged 40 years old and above, so as to provide targeted references for the screening and prevention of COPD. MethodsBased on a natural population cohort in suburban Shanghai, a total of 3 381 randomly selected participants aged ≥40 years underwent pulmonary function tests between July and October 2021. Cox stepwise regression analysis was used to develop overall and gender-specific risk prediction models, along with the construction of corresponding risk nomograms. Model predictive performance was evaluated using the C-indice, area under the curve (AUC) values, and Brier score. Stability was assessed through 10-fold cross-validation and sensitivity analysis. ResultsA total of 3 019 participants were included, with a median follow-up duration of 4.6 years. The COPD incidence density was 17.22 per 1 000 person-years, significantly higher in males (32.04/1 000 person-years) than that in females (7.38/1 000 person-years) (P<0.001). The overall risk prediction model included the variables such as gender, age, education level, BMI, smoking, passive smoking, and respiratory comorbidities. The male-specific model incorporated the variables such as age, BMI, respiratory comorbidities, and smoking, while the female-specific model included age, marital status, respiratory comorbidities, and pulmonary tuberculosis history. The C-indices for the overall, male-specific, and female-specific models were 0.829, 0.749, and 0.807, respectively. The 5-year AUC values were 0.785, 0.658, and 0.811, with Brier scores of 0.103, 0.176, and 0.059, respectively. Both 10-fold cross-validated C-indices and sensitivity analysis (excluding participants with a follow-up duration of <6 months) yielded C-indices were above 0.740. ConclusionThis study developed concise and practical overall and gender-specific COPD risk prediction models and corresponding nomograms. The models demonstrated robust performance in predicting COPD incidence, providing a valuable reference for identifying high-risk populations and formulating targeted screening and personalized management strategies.
3.Macrophage-to-myofibroblast transition promotes pulmonary fibrosis occurred in LPS-induced acute lung injury of mouse models
Dong ZHAO ; Shiqian ZHA ; Yixuan WANG ; Zhou PAN ; Wenzhen YU ; Ke HU
Basic & Clinical Medicine 2024;44(3):281-287
Objective To explore the impact of macrophage-to-myofibroblast transition(MMT)on pulmonary fibro-sis induced by acute lung injury by LPS.Methods Totally 21 male mice were randomly classified into 7 groups:control group,model group(LPS-PF)at different time points and intervention group of clodronate-liposomes(CL-LIP)treatement at different time points(n=3).Pulmonary fibrosis was identified by HE and Masson staining microscopy.The immuno-fluorescence technology was used for the evaluation of numbers of macrophage-to-myofi-broblast transition cells(MMT cell which co-expressed CD68 and α-SMA).Bone marrow-derived macrophages(BMDMs)were randomly classified into two group:control(Ctrl)group and TGF-β1-treated group induced by transforming growthfactor-β1.α-SMA,FN and Col1 were detected by RT-qPCR.The expression of α-SMA,Smad3 and p-Smad3 protein was evaluated by Western blot.Results At day 7,the Ashcroft score of lung tissue in LPS-PF mouse model was significantly increased when compared with the Ctrl group(P<0.01);While the score signifi-cantly declined when the model was pretreated with CL-LIP(P<0.05).As detected by immuno-fluorescence stai-ning,in CL-LIP group the number of CD68-positive cells co-labeled with α-SMA was obviously less then that of LPS-PF group of the corresponding time point(P<0.01).When the BMDMs were stimulated by TGF-β1 at 24 h,48 h and 96 h respectively,a higher expression of α-SMA,FN,Col1,were found in TGF-β1-treated group than that in Ctrl group at the corresponding time point(P<0.01).The expression of Smad3,p-Smad3 significantly higher in LPS-PF group(at both day 7 and day 10)and TGF-β1-treated group(at both 48 h and 96 h)as compared to cor-responding control group(P<0.01).Conclusions MMT promotes pulmonary fibrosis induced by ALI via LPS.Smad3 is proved to be involved in the MMT process.
4.Mediating effect of job burnout on occupational stress and subjective well-being among research and development enterprise employees in Minhang of Shanghai
Yixuan SUN ; Minqi WEI ; Qiuwen ZHAO ; Jinfeng YANG ; Junming DAI
Journal of Environmental and Occupational Medicine 2024;41(5):489-496
Background Under the backdrop of the national innovation-driven development strategy, the increasing occupational stress and job burnout among employees are noteworthy for their impact on employees' subjective well-being. Objective To clarify the status, distribution characteristics, and the relationship between subjective well-being, occupational stress, and job burnout of employees in research and development (R&D) enterprises, in order to improve their subjective well-being. Methods A total of 3366 employees from R&D departments at 7 enterprises in Minhang District of Shanghai were selected. The well-being level of the research subjects was investigated by using the World Health Organization Well-Being Index (WHO-5) that yielded total scores from 0 to 25, and a higher total score indicated a higher well-being level; the levels of occupational stress and job burnout were investigated by using the Chinese version of the Job Content Questionnaire, and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). The scores of WHO-5, JDC, and MBI-GS were incorporated into structural equation modeling (SEM) as numerical variables to analyze their relationship. Results The scores of subjective well-being, occupational stress, and job burnout of employees in the R&D enterprises were 13.30±6.09, 1.12±0.45, and 2.18±1.12, respectively. The positive rates of occupational stress and job burnout were 44.4% and 70.9% respectively, and the positive rate of severe job burnout was 11.7%. There were statistically significant differences in the score of subjective well-being among the participants by gender, age, educational level, marital status, registered residence, working seniority, and jobs (P<0.05); there were statistically significant differences in the positive rate of occupational stress by gender, educational level, marital status, working seniority, and jobs (P<0.05); there were statistically significant differences in the positive rate of job burnout by gender, age, educational level, marital status, registered residence, working seniority, and jobs (P<0.05). There was a negative correlation between subjective well-being and occupational stress (r=−0.1747, P < 0.01), a negative correlation between subjective well-being and job burnout (r=−0.2987, P < 0.01), and a positive correlation between occupational stress and job burnout (r=0.3342, P < 0.01). A structural equation containing partial mediating effect of job burnout on the relationship between occupational stress and subjective well-being was established, and the partial effect accounting for 52.5% of the total effect. Conclusion The job burnout among employees in R&D companies partially mediates the impact of occupational stress on subjective well-being. Reducing the level of job burnout will help alleviate occupational stress and thus improve employees' subjective well-being.
5.Mechanism of Tongxie yaofang reducing colon hypermotility in IBS-D rats by regulating gut microbiota-ENS-MM crosstalk
Long PENG ; Jiale MA ; Yixuan YIN ; Xi BU ; Shuangmei ZHAO
China Pharmacy 2024;35(13):1605-1611
OBJECTIVE To study the effects of Tongxie yaofang reducing colon hypermotility in irritable bowel syndrome with diarrhea (IBS-D) rats by regulating gut microbiota-enteric nervous system (ENS)-muscularis macrophages (MM) crosstalk. METHODS Forty newborn male SD rats were randomly divided into control group, model group, TCM group [Tongxie yaofang 2.68 g/(kg·d), calculated by raw material], and positive control group [Live combined bifidobacterium and lactobacillus tablets 0.27 g/(kg·d)], with 10 rats in each group. Except for the control group, the IBS-D model of liver stagnation and spleen deficiency syndrome was induced in the other 3 groups with the method of mother-child separation+chronic restraint+Folium Sennae- induced diarrhea. After modeling, the administration groups were given relevant drug liquid intragastrically, once a day, for consecutive 2 weeks. At the end of modeling and after administration, the fecal properties (the incidence and the rate of loose stools), colonic motility (colon emptying time), and visceral sensitivity [abdominal withdrawal reflex (AWR) scores under different pressures] of rats were observed in each group. The concentration of lipopolysaccharide (LPS) in serum was detected after medication, and the expressions and distribution of bone morphogenetic protein 2 (BMP2), colony stimulating factor 1 (CSF1) and Toll-like receptor 4 (TLR4) in colon tissue were detected; the diversity, species composition and differences of gut microbiota were also determined. RESULTS At the end of modeling, compared with the control group, all rats of the other three groups suffered from loose stools (100%), the rate of loose stools and AWR scores at different pressures increased significantly, and colon emptying time was shortened significantly (P<0.01 or P<0.05). The incidences of loose stools were 20% in TCM group and 80% in the positive control group; the rate of loose stools and AWR scores at different pressures, serum concentration of LPS and protein expressions of CSF1 and TLR4 in muscle layer of colon tissue in TCM group significantly decreased, compared with the model group; colon emptying time, the average optical density of BMP2 protein in muscle layer of colon tissue, and the indexes of Chao 1, Shannon and Faith’s PD and Simpson E-mail:772699670@qq.com index of rats in TCM group were all prolonged or increased significantly, compared with the model group (P<0.01 or P< E-mail:aiwangzi312@163.com 0.05). The relative abundance ratio of Firmicutes/Bacteroidetes, from low to high, was in the order of TCM group, control group, positive control group and model group; the species composition of gut microbiota in TCM group was closer to control group, with dominant bacterial genera including Prevotella and Blautia. CONCLUSIONS Tongxie yaofang can regulate the expressions of BMP2 and CSF1, the key proteins of gut microbiota-ENS-MM crosstalk, by changing the gut microbiota, thus alleviating the abnormal hyperfunction of colon motility in IBS-D rats.
6.Difference in Adverse Reactions between Colorectal Cancer Patients with or without Spleen-kidney Yang Deficiency Syndrome after Oxaliplatin-containing Chemotherapy
Yifan LI ; Yipang ZHAO ; Boyuan HAN ; Yixuan LIU ; Sixuan XING ; Wenjing YANG ; Qing ZHANG
Journal of Traditional Chinese Medicine 2024;65(19):2010-2017
ObjectiveTo compare the difference in adverse reactions after oxaliplatin-containing chemotherapy between colorectal cancer patients with or without spleen-kidney yang deficiency syndrome. MethodsA retrospective study was conducted using the electronic medical records of Beijing Hospital of Traditional Chinese Medicine, Capital Medical University. A total of 483 colorectal cancer patients from January 1, 2009 to December 31, 2022 were selected. Patients were divided into two groups based on their syndrome types, that was spleen-kidney yang deficiency syndrome (SKYDS) group (130 cases) and non-SKYDS group (353 cases). The incidence of adverse reactions including gastrointestinal reactions, liver damage, bone marrow suppression, and peripheral neurotoxicity after completing 2, 4, 6, and more than 6 cycles of chemotherapy was compared between the two groups. Univariate and multivariate logistic regression analyses were used to analyze the associations of age, gender, alcohol history, primary tumor location, tumor differentiation, tumor staging, chemotherapy courses, and syndrome types with the occurrence of gastrointestinal adverse reactions, liver function damage, bone marrow suppression and peripheral neurotoxicity in colorectal cancer patients who have completed 2, 4, 6 and more than 6 cycles of oxaliplatin-containing chemotherapy. ResultsThere were significant differences in the occurrence of gastrointestinal reactions after completing 2, 4, 6 and more than 6 cycles of chemotherapy between the two groups (P<0.01), with much more severe conditions in SKYDS group than non-SKYDS group (P<0.01). There was no significant difference in liver function damage and bone marrow suppression between groups (P>0.05). There were statistically significant differences in the occurrence of peripheral neurotoxicity after completion of 2 cycles (P=0.044), 4 cycles (P=0.002) and more than 6 cycles (P<0.001) of chemothe-rapy, with higher rate in SKYDS group than the non-SKYDS group (P<0.05). Univariate analysis showed that female, patients with stage Ⅲ tumors and patients having completed ≥ 6 cycles of chemotherapy had a higher incidence of bone marrow suppression (P<0.05), and patients with SKYDS had a higher incidence of gastrointestinal reactions (P<0.001). Patients with a history of drinking, stage Ⅳ cancer, and ≥6 cycles of chemotherapy had a higher incidence of liver function injury (P<0.05). Patients with stage Ⅲ cancer, ≥6 cycles of chemotherapy, and SKYDS had a higher incidence of peripheral neurotoxicity (P<0.05). Multivariate analysis showed that the risk factor for bone marrow suppression was chemotherapy ≥6 cycles (P=0.001), and SKYDS was the risk factor for gastrointestinal reaction (P<0.001). The risk factor for liver function damage was tumor stage Ⅳ (P=0.001) and SKYDS (P=0.039). All variables had no significant correlation with the occurrence of peripheral neurotoxicity. ConclusionFor colorectal cancer patients, being diagnosed with SKYDS is a risk factor for developing gastrointestinal adverse reactions and peripheral neurotoxicity following chemotherapy with an oxaliplatin-based regimen.
7.Correlation Analysis Between Ultrasonic Epiphysis Cartilage Thickness and Bone Age
Zeqing ZHAO ; Shi CHEN ; Li ZHANG ; Yixuan ZHANG ; Yamei YANG ; Yilin GU ; Fengdan WANG ; Hui PAN ; Xiao YANG ; Jianchu LI
Medical Journal of Peking Union Medical College Hospital 2024;15(3):694-701
Preliminary exploration of using ultrasound to quantitatively evaluate the development of epiphyseal cartilage and analyze its correlation with bone age, based on the ultrasound findings of the long bone joint end. A study was conducted on adolescents studying at a sports school in Jining from March to June 2023. Age, height and other information were recorded. Bone age assessment by X ray were performed within 1 week with an endocrinologist interpreted the bone age using the Greulich-Pyle atlas. Two sonographers scanned a total of 7 sites in the hand, wrist and knee joint of the non-dominant side (including the dorsal side of the third metacarpal head, the ulnar styloid process, the radial styloid process, the medial and the lateral femoral epicondyle, dorsal tibia, and medial tibial condyle). The ultrasonic epiphyseal cartilage thickness (UECT) was measured and its correlation with bone age was analyzed. Intraclass correlation coefficient (ICC) was used to evaluate the reliability and repeatability of UECT measurement. A total of 141 adolescents were included, with 80 males and 61 females. The average age was 13 (12-14) years old. The average bone age was 15(13-17) years in males and 16 (14-17) years in females. The proportion of the males and females whose bone age was 1 year older than chronological age was 60% and 67%, respectively, and the height of the males was significantly higher than that of the females( Ultrasound can observe and describe the developmental change of long bone, and UECT has potential value in quantitative evaluation of bone maturity.
8.Area Ossification Ratio: A New Parameter for Quantitative Assessment of Adolescent Bone Age by Conventional Ultrasonography
Yamei YANG ; Li ZHANG ; Yixuan ZHANG ; Zeqing ZHAO ; Yilin GU ; Shi CHEN ; Hui PAN ; Fengdan WANG ; Xiao YANG ; Jianchu LI
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1192-1197
To research on area ossification ratio (AOR), a novel parameter for quantitatively assessing adolescent bone age by conventional ultrasonography, and evaluate the correlation between AOR and radiographic bone age. The study selected healthy adolescents from a middle school in Shandong Province in June 2023. Ultrasonic images were collected from five anatomical sites (the styloid process of the ulna, the styloid process of the radius, the lateral epicondyle of the femur, the medial condyle of the tibia, and the posterior median sagittal plane of the tibia). The second ossification center and epiphyseal area on these 2D ultrasound images were delineated to calculate AOR. This ratio was then compared with radiographic bone age measured by Greulich-Pyle (GP) atlas. Inter- and intra-observer consistency was evaluated using intraclass correlation coefficient (ICC) and the Bland-Altman method. A total of 179 healthy adolescents (109 males and 70 females) were included. For both genders, AOR of each site exhibited a significant to high correlation with radiological bone age ( The sum of AORs in adolescents is highly correlated with radiographic bone age, and the measurement method shows high repeatability. The AOR is a reliable parameter for the ultrasonic quantitative assessment of bone age in adolescents.
9.Correlation Analysis Between Ultrasound Ossification Ratio and Exercise Intensity in Adolescents
Li ZHANG ; Hanze DU ; Yixuan ZHANG ; Yamei YANG ; Zeqing ZHAO ; Xiaoyuan GUO ; Shi CHEN ; Hui PAN ; Xiao YANG ; Jianchu LI
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1198-1203
To evaluate the correlation between ultrasound ossification ratio(OR) and exercise intensity among adolescents. This cross-sectional study used stratified sampling to select adolescents aged 11-15 years from a sports school and some ordinary middle schools in Shandong Province in June 2023. The participants were divided into two groups: competitive sports group (high exercise intensity), and general sports group (moderate exercise intensity), based on their exercise intensity. Ultrasound images of long bones from nine body regions (including 3 upper limb bones and 6 lower limb bones) were collected for both groups. Two sonographers interpreted the images and calculated the ultrasound OR values (the ratio of ossification center length to epiphyseal length on the standard ultrasound section). The intraclass correlation coefficient (ICC) was used to assess the consistency of image interpretation between the observers. Differences in ultrasound OR values between the two groups were compared, and multivariate Logistic regression analysis was performed to assess the correlation between ultrasound OR values and exercise intensity. A total of 252 adolescents who met the inclusion and exclusion criteria were included, with 154 in the competitive sports group (97 males and 57 females) and 98 in the general sports group (52 males and 46 females). The median height and average daily exercise duration were significantly higher in the competitive sports group than in the general sports group (all The medial femoral ultrasound OR value was correlated with exercise intensity among adolescents. This indicator may serve as an objective imaging parameter for assessing whether adolescent exercise meets recommended standards.
10.Ferroptosis inducer Erastin inhibits proliferation of liver cancer cells in vitro by down-regulating ACSL4
Peipei ZHAO ; Zhigang ZHOU ; Yuanyuan YANG ; Shusheng HUANG ; Yixuan TU ; Jian TU
Journal of Southern Medical University 2024;44(11):2131-2136
Objective To investigate the expression of Acyl-CoA synthetase long-chain family member 4(ACSL4)in liver cancer and its role in regulating ferroptosis and proliferation of liver cancer cells.Methods Clinical samples of liver cancer and adjacent normal liver tissues were examined for malondialdehyde(MDA)contents and for expressions of mRNA and protein expressions of ACSL4 and proliferating cell nuclear antigen(PCNA)using RT-qPCR and Western blotting.Human liver cancer Huh-7 cells were treated with Erastin(a ferroptosis inducer),Fer-1(a ferroptosis inhibitor),or both,and the changes in expression levels of MDA,ACSL4 and PCNA were detected,and the cell proliferation was assessed with plate cloning assay.Results MDA contents were lower and ACSL4 and PCNA expressions were higher significantly in liver cancer tissues than in adjacent liver tissues.In Huh-7 cells,Erastin treatment significantly inhibited mRNA and protein expressions of ACSL4 and PCNA,suppressed cell proliferation,and increased MDA contents.Fer-1 alone did not produce significant effect on cell viability but reversed the effect of Erastin on ACSL4 and PCNA expressions,cell proliferation and MDA contents.Conclusion ACSL4 level is significantly overexpressed in liver cancer.Erastin increases MDA contents and down-regulates ACSL4 expression,thereby promoting ferroptosis and inhibiting proliferation of liver cancer cells,and these effects can be reversed by Fer-1.

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