1.Construction and application of the project approval evaluation system for traditional Chinese medicine prepara-tion in medical institutions
Xiaoyu JU ; Liang ZHAO ; Yue ZHAO ; He TANG ; Jingyi ZHANG ; Junxue LI ; Yurun XUE ; Shengjiang GUAN ; Jie CHENG
China Pharmacy 2024;35(10):1168-1173
OBJECTIVE To establish the project approval evaluation system for traditional Chinese medicine (TCM) preparations in medical institutions guided by new drug conversion, to improve the success rate of approval for TCM preparations in medical institutions and lay the foundation for the later drug conversion. METHODS Research and development team used the literature research method and brainstorming method to list and organize relevant elements of project evaluation and determine the initial indicator system. Experts were consulted using the Delphi method to confirm the evaluation index. The weights were calculated based on the proportion of importance scores for each indicator and assigned specific scores to each item. The indicator system was used to evaluate 31 TCM preparations applied for filing by various departments of our hospital from April to July 2023. RESULTS After two rounds of 17 experts’ consultation, the final TCM preparation system included five primary indicators, i.e. theoretical basis, clinical research foundation, pharmaceutical foundation, prescription, and clinical value, as well as 17 secondary indicators including prescription source, traditional Chinese medicine theory, clinical positioning and so on. Human experience was considered as the item which would be rejected as one vote. Based on the above indicator system, our hospital further improved the filing and project approval process for TCM preparations in medical institutions. Among the 31 TCM preparations applied for filing by various departments from April to July 2023, 8 TCM preparations with a score ≥65 were selected for development. CONCLUSIONS The evaluation system is objective, comprehensive, and highly operable. It is suitable for the selection of TCM preparations in medical institutions before research and development.
2.Regulation mechanism of the quorum sensing regulator AphA on the type Ⅵ secretion system VflT6SS2 in Vibrio fluvialis
Qian CHENG ; Yu HAN ; Yuanming HUANG ; Saisen JI ; Jie LI ; Baowei DIAO ; Weili LIANG
Chinese Journal of Epidemiology 2024;45(4):566-573
Objective:To explore the regulation mechanism of the quorum sensing regulator AphA on the functional activity of type Ⅵ secretion system VflT6SS2 in Vibrio fluvialis. Methods:Western Blot analysis was used to detect the relative expression and secretion of VflT6SS2 signature component hemolysin-coregulated protein (Hcp) in wild type (WT), Δ aphA, and corresponding complementary strains. Quantitative reverse transcription PCR and luminescence activity assay of the promoter- lux fusion system was used to measure the mRNA expression levels and promoter activity of the VflT6SS2 core and accessory gene-cluster representative genes tssB2, hcp ( tssD2) and vgrG ( tssI2), and the quorum sensing regulator HapR in WT and Δ aphA strains. A point mutation experiment combined with a luminescence activity assay was used to verify the regulatory binding site of AphA in the tssD2b promoter region. Electrophoretic mobility shift assay (EMSA) was used to determine AphA binding to the hapR promoter. Results:The mRNA expression levels of tssB2, hcp( tssD2), vgrG ( tssI2), and hapR as well as the protein expression and secretion levels of Hcp in Δ aphA strain, were significantly higher than those in the WT strain. The promoter activities of the VflT6SS2 core cluster, tssD2a, tssI2a, and hapR were higher in Δ aphA strain than in the WT strain, while the promoter activity of tssD2b showed the opposite trend. The promoter sequence analysis of tssD2a and tssD2b found significant differences in the region from -335 bp to -229 bp, and two potential AphA binding sites on tssD2b. The promoter activity of tssD2b decreased significantly after the point mutation of the two potential AphA binding sites. EMSA results showed that AphA binds directly to the promoter region of hapR. Conclusions:AphA indirectly inhibits the regulation of the VflT6SS2 core and accessory gene clusters at the promoter level by directly repressing the expression of hapR. AphA showed opposite regulation patterns for tssD2a and tssD2b, and AphA could positively regulate the expression of tssD2b by directly binding to the tssD2b promoter region (-335 bp to -229 bp).
3.Screening and identification of xanthine oxidase inhibitors from Smilax glabra
Hui-Liang ZOU ; Ke CHEN ; Xin-Cai WANG ; Xiao CHENG ; Ling-Jie MENG ; Bai-Lian LIU ; Min CHEN
Chinese Traditional Patent Medicine 2024;46(5):1558-1564
AIM To rapidly screen xanthine oxidase(XOD)inhibitors from Smilax glabra Roxb.by enzyme-immobilized magnetic microspheres and LC-MS/MS,and to confirm the anti-uric acid constituents from S.glabra Roxb.METHODS The immobilized xanthine oxidase was prepared by covalent coupling with carboxyl magnetic beads as a carrier.The xanthine oxidase inhibitors in S.glabra were screened by the specific adsorption of immobilized enzyme.LC-MS/MS and standard substances were used for analysis and comparison,and the inhibitory activity and inhibition type of the screened and identified components were investigated.RESULTS The successful synthesis of immobilized xanthine oxidase was characterized by scanning electron microscopy and infrared spectroscopy.The enzyme loading was 70.50 μg/mg and the relative activity was 79.44%.Thirteen active compounds were screened from the extract of S.glabra,and eleven compounds were identified.The enzyme activity test showed that the inhibitory activites of engeletin and isoengeletin were the strongest,which was close to the positive control allopurinol.The IC50 value and inhibition type were 32.25 μg/mL,mixed inhibition,35.12 μg/mL,competitive inhibition.CONCLUSION The method is simple,rapid,accurate and suitable for directly screened active ingredients which can inhibit XOD from complex extract of traditional Chinese medicines.
4.Effects of Compound Dihuang Granules on biological function of dopaminergic neurons in rats with Parkinson's disease of Pattern of Yin-Deficiency with Stirring Wind
Xing-Ling WANG ; Jian-Qing LIANG ; Guang-Jie SUN ; Zi-Wei LÜ ; Jian-Cheng HE
Chinese Traditional Patent Medicine 2024;46(6):1828-1835
AIM To investigate the effects of Compound Dihuang Granules on biological function of dopaminergic neurons in rats with Parkinson's disease(PD)of Pattern of Yin-Deficiency with Stirring Wind.METHODS The PD animal model of Pattern of Yin-Deficiency with Stirring Wind established by intracerebral injection of 6-hydroxydopamine(6-OHDA)were randomly divided into the model group,the Midoba group(150 mg/kg)and the low,medium and high dose Compound Dihuang Granules groups(1.75,3.5 and 7 g/kg)for corresponding drug intervention,in contrast to the normal group,the sham operation group and the model group underwent 28-day normal saline administration.The rats had their general condition and neuroethology observed;their pathological changes of substantia nigra observed by HE staining;their mitochondrial structure of dopaminergic neurons in the damaged substantia nigra observed by transmission electron microscopy;and their expressions of DJ-1,IP3R,GRP75 and VDAC1 detected by immunohistochemistry,Western blot and RT-qPCR.RESULTS Compared with the normal group and sham operation group,the model group displayed increased rotational behavirors(P<0.01),decreased swimming time score(P<0.01),decreased hanging time(P<0.01),decreased number of neurons in substantia nigra but more neurons with morphological damage,mitochondrial swelling and degeneration,mitochondrial crista disappearance,and decreased expressions of DJ-1,IP3R,GRP75 and VDA C1 mRNA and protein in the injured side(P<0.01).Compared with the model group,the Midoba group and the Compound Dihuang Granules groups demonstrated less rotational behavirors(P<0.01),higher swimming time score(P<0.01),longer hanging time(P<0.01),less damage to mitochondrial morphology and structure,and higher expressions of DJ-1,IP3R,GRP75 and VDA C1 mRNA and protein in the injured substantia nigra(P<0.05,P<0.01).The high-dose Compound Dihuang Granules presented equivalent efficacy to that of Midoba.CONCLUSION Compound Dihuang Granules may promote endoplasmic reticulum-mitochondria homeostasis,reduce mitochondrial damage and maintain the biological function of dopaminergic neurons by regulating the expressions of DJ-1,IP3R,GRP75 and VDAC1.
5.Observation on the Therapeutic Effect of Zishen Jianpi Quyu Formula in the Treatment of Migraine Without Aura of Kidney Deficiency and Blood Stasis Type
Hao-Tao FANG ; Yu-Xuan YE ; Ru-Cheng HUANG ; Jie KONG ; Zhi-Ru ZHANG ; Huan-Huan LIANG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(11):2936-2942
Objective To investigate the clinical efficacy and safety of Zishen Jianpi Quyu Formula in treating patients with migraine without aura in the postmenstrual period of kidney deficiency and blood stasis type.Methods A total of 104 patients with migraine without aura of kidney deficiency and blood stasis type were randomly divided into the control group and the trial group,with 52 cases in each group.The control group was treated with Flunarizine Hydrochloride Capsules,and the trial group was treated with Zishen Jianpi Quyu Formula on the basis of treatment for the control group.One menstrual cycle constituted a course of treatment,and the treatment covered a total of two courses(eight weeks).The changes of traditional Chinese medicine(TCM)syndrome score,migraine attack frequency,duration of migraine headaches,visual analogue scale(VAS)score of migraine headache intensity,Headache Impact Test-6(HIT-6)score and hemorheology indexes in the two groups before and after treatment were observed.Moreover,the efficacy for TCM syndrome and clinical safety in the two groups were evaluated.Results(1)After two courses of treatment,the total effective rate of the trial group was 90.38%(47/52),and that of the control group was 69.23%(36/52),the intergroup comparison(by chi-square test)showed that the efficacy for TCM syndrome in the trial group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores of the patients in both groups were significantly lower than those before treatment(P<0.05),and the reduction of TCM syndrome score in the trial group was significantly superior to that in the control group(P<0.05).(3)After treatment,the migraine attack frequency,duration of migraine headaches,VAS scores of migraine headache intensity in the two groups of patients were significantly improved compared with those before treatment(P<0.05),and the improvement of migraine headache parameters in the trial group was significantly superior to that in the control group(P<0.05).(4)After treatment,the HIT-6 score in the two groups was decreased significantly compared with those before treatment(P<0.05),and the decrease of HIT-6 score in the trial group was significantly superior to that in the control group(P<0.05).(5)After treatment,hemorheology indexes(including plasma viscosity,whole blood high-shear viscosity,whole blood low-shear viscosity,fibrinogen,and hematocrit)in the two groups were improved compared with those before treatment(P<0.05),and the improvement of each of hemorheology indexes in the trial group was significantly superior to that in the control group(P<0.05).(6)During treatment,no serious adverse events occurred in the two groups,which was of high safety.Conclusion Zishen Jianpi Quyu Formula exerts remarkable clinical efficacy in treating patients of migraine without aura in the postmenstrual period of kidney deficiency and blood stasis type.The formula is effective on improving the TCM syndromes and migraine attacks of the patients,achieving the efficacy of milder headache,lower attack frequency and shorter duration,more stability hemorheology indexes and higher safety.
6.Research on recruitment strategies for public hospital physicians based on competency models:a case study of public hospitals in Guangzhou
Lianhuan LI ; Weijiang ZHENG ; Jie LONG ; Liang CHENG
Modern Hospital 2024;24(10):1568-1570,1574
Medical talent is the core competitive strength for the development of hospitals.Effective recruitment helps hospitals select talents that meet the demands of high-quality development.This article takes public hospitals in Guangzhou as an example and employs literature review and interviews to construct a competency model for public hospital physicians.This model encompasses six dimensions and 20 elements,including clinical skills,knowledge proficiency,professional spirit and qualities,teamwork ability,doctor-patient communication skills,and lifelong learning ability.The established model is applied to various recruitment modules,such as defining recruitment needs,expanding recruitment channels,selecting candidates,standardizing recruitment processes,and improving recruitment evaluation systems,thereby proposing corresponding recruitment strategies for public hospital physicians.
7.Nucleic acid positive rate and genotype characteristics analysis among patients with viral hepatitis C in Yongchuan District of Chongqing city during 2004-2022
Huan WU ; Jie XU ; Qin LI ; Liang CHENG ; Fen ZHAO ; Xuefei JIANG
Chongqing Medicine 2024;53(17):2668-2671,2681
Objective To analyze the nucleic acid positive rate and genotype characteristics of the pa-tients with viral hepatitis C in Yongchuan District of Chongqing city during 2004-2022.Methods All the hepatitis C patients whose current address was in Yongchuan District of Chongqing City and audited for man-agement entering in the database of the Infectious disease surveillance System of China Disease Prevention and Control Information from 2004 to 2022 were selected as the study subjects.The questionnaire survey,nucleic acid and genotype detection were conducted.The nucleic acid positive rate and genotype characteristics were analyzed.Results Among 489 cases of viral hepatitis C,there were 286 cases of hepatitis C viral nucleic acid(HCV-RNA)positive(58.49%),the positive rate of males was 64.63%,which was high than 49.23%in fe-males,and the differences was statistically significant(P<0.05).The HCV-RNA positive rate had statistical difference among different professions,cultural levels and medical insurance types(P<0.05).But the HCV-RNA positive rates had no statistically difference among different ages,marital status,incomes and permanent residences(P>0.05).A total of 285 cases of single infection subtype and 1 case of 1b and 6a mixed subtype were detected out.The single infection subtypes were mainly the 1b type(56.45%),3b type(12.89%)and 6a type(13.24%).Conclusion The positive rate of HCV-RNA among hepatitis C patients in Yongchuan Dis-trict during 2004-2022 was 58.49%,more than half of the previous cases are still the active infected persons requiring the antiviral treatment.The HCV genotype is mainly the 1b type,followed by 3a,3b and 6a types.It is necessary to further mobilize the treatment of previous patients with hepatitis C and improve the treatment rate and clinical cure rate.
8.Single cell analysis unveils B cell-dominated immune subtypes in HNSCC for enhanced prognostic and therapeutic stratification
Li KANG ; Zhang CAIHUA ; Zhou RUOXING ; Cheng MAOSHENG ; Ling RONGSONG ; Xiong GAN ; Ma JIEYI ; Zhu YAN ; Chen SHUANG ; Chen JIE ; Chen DEMENG ; Peng LIANG
International Journal of Oral Science 2024;16(3):448-459
Head and neck squamous cell carcinoma(HNSCC)is characterized by high recurrence or distant metastases rate and the prognosis is challenging.There is mounting evidence that tumor-infiltrating B cells(TIL-Bs)have a crucial,synergistic role in tumor control.However,little is known about the role TIL-Bs play in immune microenvironment and the way TIL-Bs affect the outcome of immune checkpoint blockade.Using single-cell RNA sequencing(scRNA-seq)data from the Gene Expression Omnibus(GEO)database,the study identified distinct gene expression patterns in TIL-Bs.HNSCC samples were categorized into TIL-Bs inhibition and TIL-Bs activation groups using unsupervised clustering.This classification was further validated with TCGA HNSCC data,correlating with patient prognosis,immune cell infiltration,and response to immunotherapy.We found that the B cells activation group exhibited a better prognosis,higher immune cell infiltration,and distinct immune checkpoint levels,including elevated PD-L1.A prognostic model was also developed and validated,highlighting four genes as potential biomarkers for predicting survival outcomes in HNSCC patients.Overall,this study provides a foundational approach for B cells-based tumor classification in HNSCC,offering insights into targeted treatment and immunotherapy strategies.
9.Spatial distribution pattern of local tumor progression analysis after microwave ablation of hepatocellular carcinoma based on three-dimensional magnetic resonance imaging
Fangying FAN ; Wenzhen DING ; Fangyi LIU ; Zhigang CHENG ; Zhiyu HAN ; Xiaoling YU ; Ping LIANG ; Jie YU
Chinese Journal of Hepatology 2024;32(3):208-213
Objective:To investigate the spatial distribution pattern of local tumor progression (LTP) for hepatocellular carcinoma (HCC) ≤5 cm after microwave ablation.Methods:A retrospective analysis was performed on 169 HCCs with matched MRI before and after ablation from December 2009 to December 2019. A tumor MRI was reconstructed using three-dimensional visualization technology. LTP was classified as contact or non-contact, early or late stage, according to whether LTP was in contact with the edge of the ablation zone and the occurrence time (24 months). The tumor-surrounded area was divided into eight quadrants by using the eight-quadrant map method. An analysis was conducted on the spatial correlation between the quadrant where the ablative margin (AM) safety boundary was located and the quadrant where different types of LTP occurred. The t-test, or rank-sum test, was used for the measurement data. 2-test for count data was used to compare the difference between the two groups.Results:The AM quadrant had a distribution of 54.4% LTP, 64.2% early LTP stage, and 69.1% contact LTP, suggesting this quadrant was much more concentrated than the other quadrants ( P ?0.001). Additionally, the AM quadrant had only 15.2% of non-contact type LTP and 17.1% of late LTP, which was not significantly different from the average distribution probability of 12.5% (100/8%) among the eight quadrants ( P = 0.667, 0.743). 46.6% of early contact type LTP was located at the ablation needle tip, 25.2% at the body, and 28.1% at the caudal, while the location distribution probabilities of non-early contact LTP were 34.8%, 31.8%, and 33.3%, respectively. Conclusion:LTP mostly occurs in areas where the ablation safety boundary is the shortest. However, non-contact LTP and late LTP stages exhibit the feature of uniform distribution. Thus, this type of LPT may result from an inadequate non-ablation safety boundary.
10.Curative effect of percutaneous microwave ablation therapy on hepatocellular carcinoma survival: a 15-year real-world study
Yanchun LUO ; Manlin LANG ; Wenjia CAI ; Zhiyu HAN ; Fangyi LIU ; Zhigang CHENG ; Xiaoling YU ; Jianping DOU ; Xin LI ; Shuilian TAN ; Xuejuan DONG ; Ping LIANG ; Jie YU
Chinese Journal of Hepatology 2024;32(4):332-339
Objective:To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma.Methods:2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival.Results:A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P ?0.001, especially for liver cancer 3.1~5.0 cm ( P ?0.001). Conclusion:Microwave ablation therapy is a safe and effective method for BCLC stage 0-B, with significantly enhanced technical efficacy and survival rate over time.

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