1.Research Path and Paradigm of Digitization and Intelligentization of Ancient TCM Books Based on the Deep Integration of Knowledge Element Theory and Clinical Needs
Feng YANG ; Yi ZHANG ; Xiaohua TAO ; Jianfeng LI ; Tao LUO ; Jingling CHANG ; Jian CHEN ; Liyun CHEN ; Ming DAI ; Fenglan WANG ; Xiang LU
Journal of Traditional Chinese Medicine 2024;65(12):1201-1207
		                        		
		                        			
		                        			With the rapid development of information technology, research on ancient TCM books has shifted from the traditional collation and digitization into intelligent knowledge service, thereby achieving the deep integration of ancient TCM books collation and clinical needs. Based on the clinical problem and knowledge element theory, we implemented in-depth indexing and knowledge mining for 600 kinds of ancient TCM books, built a knowledge sharing service platform for ancient TCM books by integrating database, cloud platform, knowledge graph and other technologies, and carried out the thematic literature research and developed databases for four major diseases including stroke, heart failure, liver cirrhosis, and diabetes. The digital intelligence products have been applied in hundreds of hospitals for evaluation and feedback. Finally, through "digital processing plus intelligent application", the two-way interaction between ancient TCM books and current clinical practice is realized, and the path and paradigm of ancient TCM books knowledge serving the modern prevention and control of major diseases is formed, providing reference for the innovative utilization of ancient TCM books. 
		                        		
		                        		
		                        		
		                        	
2.Assessment and preliminary clinical application of a domestic nucleic acid detection reagent for hepatitis D virus
Yongcong LI ; Rongchen YUAN ; Kuanhui XIANG ; Guomin OU ; Tianxun HUANG ; Fangming CHENG ; Zhenchao TIAN ; Xiongwei LIU ; Xiaozhong WANG ; Feng GUO ; Yahong MA ; Jing ZHOU ; Erhei DAI ; Bangning CHENG ; Tong LI ; Tao SHEN ; Chungen QIAN
Chinese Journal of Laboratory Medicine 2024;47(3):239-244
		                        		
		                        			
		                        			Objective:This study aims to evaluate the quality and explore the preliminary clinical applications of a domestically developed hepatitis D virus nucleic acid quantification reagent (abbreviated as"domestic HDV RNA reagent").Methods:The sensitivity and accuracy of the reagent were evaluated in accordance with the WHO HDV RNA international standard, employing the Bio-Rad CFX Opus 96 real-time fluorescence quantitative PCR analysis system. Serial dilutions of pseudo-viruses or cell culture-derived virus were used to determine the linear range of the domestic HDV RNA reagent. Specificity was assessed using positive samples of HAV, HBV, HCV infection, and HEV national reference materials. Precision was evaluated with samples at both high and low concentrations. In a comparative analysis, 30 HDV IgG positive samples were tested using both the domestic HDV RNA reagent and the RoboGene HDV RNA kit based on the ABI 7500 FAST DX system. The Pearson correlation coefficient (r) was used to examine the correlation between the two reagents.Results:The domestic HDV RNA reagent demonstrated a high sensitivity of up to 6 IU/ml, consistent with that of the comparator reagent. The calibration curve for WHO HDV RNA standards had a slope of -3.286, with an amplification efficiency of 101.6%. The linear detection range spanned from 10 to 10 8 IU/ml for eight HDV genotypes. The domestic HDV RNA reagent exhibited exceptional specificity, without cross-reactivity observed with HAV, HBV, HCV, or HEV. Accuracy assessments at five concentration levels met the required standards, with intra-assay precision coefficient of variation ( CV) ranging from 1.20% to 4.20%, and inter-assay precision CV from 1.20% to 7.90%. The detection results for HDV IgG positive samples were highly correlated with the comparator reagent ( r=0.984, P<0.001), achieving a diagnostic accuracy of 100% compared to sequencing results. Conclusion:In this study, the domestic HDV RNA reagent possesses excellent specificity, accuracy, precision, and a broad linear range, attaining a sensitivity level on par with international reagents of the same type.
		                        		
		                        		
		                        		
		                        	
3.Advances in HIV-1 latency-regulating agents
Jiao-jiao DAI ; Xiang-yi JIANG ; Da FENG ; Hao LIN ; Xin-yong LIU ; Peng ZHAN
Acta Pharmaceutica Sinica 2024;59(4):840-852
		                        		
		                        			
		                        			 At present, there is no cure for acquired immune deficiency syndrome (AIDS) due to HIV-1 latent reservoirs. Therefore, it urgently requires novel HIV-1 latency-regulating agents with high potency, low toxicity and favorable drug-like properties to achieve a functional cure for AIDS. Herein, we reviewed the advances in HIV-1 latency-regulating agents since 2019, including the drug discovery strategies, bioactivities, and mechanisms of these compounds. It is of great guiding significance in the development of latency-regulating agents with clinical value. 
		                        		
		                        		
		                        		
		                        	
4.Research Progress in the Treatment of Depression by Baihe Dihuang Decoction and Its Associated Formulas
Feng-Xiang DAI ; Hai-Bin HUANG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(11):3078-3083
		                        		
		                        			
		                        			Baihe Dihuang Decoction is a classic formula recorded in Jin Gui Yao Lve(Synopsis of the Golden Chamber),which has the actions of nourishing yin and clearing heat,tonifying heart and lung.Baihe Dihuang Decoction and its associated formulas are widely used for the treatment of depression,insomnia,women's menopausal syndrome and other psychiatric disorders.This article retrieved the relevant literature about Baihe Dihuang Decoction and its associated formulas such as Baihe Zhimu Decoction and Baihe Jizi Decoction for the treatment of depression in recent years,and analyzed the clinical application and the possible pharmacological mechanisms of Baihe Dihuang Decoction and its associated formulas for the treatment of depression.The analysis showed that Baihe Dihuang Decoction and its associated formulas were indicated for the patients with internal heat due to yin deficiency syndrome,and their antidepressive mechanism is related to up-regulating the levels of monoamine neurotransmitters and the expression of brain-derived neurotrophic factors,inhibiting inflammatory responses,protecting neurons and regulating energy metabolism.The analysis results for the clinical application and possible therapeutic mechanism of Baihe Dihuang Decoction and its associated formulas in counteracting depression will provide reference for the clinical treatment and basic research of depression.
		                        		
		                        		
		                        		
		                        	
5.Clinical curative effect of HAT therapy on septic shock
Yao DAI ; Xiang FANG ; Kang HUANG ; Jie FENG ; Min LIU ; Songbai WU
Tianjin Medical Journal 2024;52(8):825-829
		                        		
		                        			
		                        			Objective To explore the curative effect of hydrocortisone ascorbic acid,vitamin C and vitamin B1(HAT)therapy on septic shock and its influence on the time of vasoactive drug application,hemodynamic parameters and short-term prognosis.Methods According to different treatment plans,92 patients with septic shock were divided into the HAT group and the routine treatment group,46 cases in each group.The routine treatment group was given routine treatments[anti-infection,fluid replacement,stabling blood pressure and continuous renal replacement therapy(CRRT)],while the HAT group was additionally given HAT therapy.All patients were treated continuously for 3 d.The indexes related the curative effect,scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA),levels of mean arterial pressure(MAP),heart rate(HR),central arterial pressure(CAP),D-lactic acid(D-Lac),creatinine(Cr),hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT)before and after treatment,incidence of adverse reactions and 28 d survival rate by follow-up were compared between the two groups.Results The circulation stabilization time,use time of vasoactive drugs and hormones,mechanical ventilation time,CRRT time,treatment time in ICU and total hospitalization time were shorter in the HAT group than those in the routine treatment group(P<0.05).After 7 d of treatment,scores of APACHE Ⅱ and SOFA,levels of HR,D-Lac,Cr,hs-CRP and PCT were lower in the HAT group than those in the routine treatment group,while MAP and CAP were higher than those in the routine treatment group(P<0.05).The 28-day survival rate was 65.22%in the HAT group,which was higher than that in the routine treatment group(45.65%,P<0.05).Conclusion HAT therapy can improve clinical curative effect in patients with septic shock,shorten use time of vasoactive drugs,improve hemodynamic parameters and short-term prognosis.
		                        		
		                        		
		                        		
		                        	
6.Effects of Body Weight and Waist Circumference on Balance Function in Overweight and Obese Adults
Wei XIN ; Yi-ying MAI ; Xi-xiang TANG ; He-fang WU ; Yao SHEN ; Jian-ming YAO ; Dong-feng XIE ; Yan-ming CHEN
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(4):551-559
		                        		
		                        			
		                        			ObjectiveTo explore the effects of body weight and waist circumference on static and dynamic balance function in overweight and obese adults. MethodsParticipants (n=103) were selected by cluster random sampling from the Hypoglycemic Weight Loss Clinic of the Endocrinology Department of the Third Affiliated Hospital of Sun Yat-sen University. All participants were assessed for basic data collection, biochemical test, body weight, waist circumference and height measurement, static balance function assessed by balance error scoring system (BESS) and dynamic balance function assessed by functional reach test (FRT). The BESS score and FRT distance of all participants were compared among groups according to different BMI grades and WC grades. Multivariate linear regression was used to analyze the influencing factors of participants' dynamic and static balance functions. Results① With the increase of BMI grading, the BESS score showed an upward trend, and the difference between groups was statistically significant (P = 0.004). The BESS score of normal WC patients was lower than that of central obesity patients (P < 0.001), which indicated that compared with normal BMI, overweight and obese people had poor dynamic and static balance ability; ② With the BMI grading, the FRT distance increased, showing a downward trend (P < 0.001). The FRT distance in normal WC patients was significantly higher than that in central obesity patients (P < 0.001), which indicated that the static and dynamic balance ability of central obesity patients was worse than that of normal WC patients; ③ In BMI overweight group, the FRT distance decreased significantly with the increase of WC (P = 0.02). The results showed that under the condition of no difference in BMI, Compared with normal WC, the dynamic and static balance ability of central obese patients was worse; ④ The influence of BESS score on BMI(B=4.12,P =0.027, 95% CI=0.48-7.75)and WC(B = 3.47,P = 0.046, 95% CI = 0.07 - 6.88)was significant. The influence of FRT distance on BMI(B = -5.68,P = 0.001, 95% CI = -8.95 - 2.41)and WC(B = -4.71,P = 0.003, 95% CI = -7.83 to -1.61)was significant, which indicated that the static and dynamic balance ability of obese people was worse with the increase of BMI, and the ability of dynamic and static balance of central obesity was worse than that of normal WC. ConclusionWaist circumference is an independent factor affecting the dynamic and static balance function of overweight and obese people. Under similar BMI, the dynamic balance function of central obese people is worse than that of people with normal waist circumference, leading to higher risk of falling. 
		                        		
		                        		
		                        		
		                        	
7.Chinese Guideline on the Management of Polypoidal Choroidal Vasculopathy (2022).
You-Xin CHEN ; Yu-Qing ZHANG ; Chang-Zheng CHEN ; Hong DAI ; Su-Yan LI ; Xiang MA ; Xiao-Dong SUN ; Shi-Bo TANG ; Yu-Sheng WANG ; Wen-Bin WEI ; Feng WEN ; Ge-Zhi XU ; Wei-Hong YU ; Mei-Xia ZHANG ; Ming-Wei ZHAO ; Yang ZHANG ; Fang QI ; Xun XU ; Xiao-Xin LI
Chinese Medical Sciences Journal 2023;38(2):77-93
		                        		
		                        			
		                        			Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.
		                        		
		                        		
		                        		
		                        	
8.Guideline for clinical comprehensive evaluation of Chinese patent medicine (2022 version).
Wei-An YUAN ; Jun-Hua ZHANG ; Jian-Ping LIU ; Zhong-Qi YANG ; Jun-Ling CAO ; Xing LIAO ; Xiao-Yu XI ; Mei HAN ; Wen-Yuan LI ; Zhen-Wen QIU ; Shi-Yin FENG ; Yuan-Yuan GUO ; Lu-Jia CAO ; Xiao-Hong LIAO ; Yan-Ling AI ; Ju HUANG ; Lu-Lu JIA ; Xiang-Fei SU ; Xue WU ; Ze-Qi DAI ; Ji-Hua GUO ; Bing-Qing LU ; Xiao-Xiao ZHANG ; Jian-Yuan TANG
China Journal of Chinese Materia Medica 2023;48(1):256-264
		                        		
		                        			
		                        			Currently,the research or publications related to the clinical comprehensive evaluation of Chinese patent medicine are increasing,which attracts the broad attention of all circles. According to the completed clinical evaluation report on Chinese patent medicine,there are still practical problems and technical difficulties such as unclear responsibility of the evaluation organization,unclear evaluation subject,miscellaneous evaluation objects,and incomplete and nonstandard evaluation process. In terms of evaluation standards and specifications,there are different types of specifications or guidelines with different emphases issued by different academic groups or relevant institutions. The professional guideline is required to guide the standardized and efficient clinical comprehensive evaluation of Chinese patent medicine and further improve the authority and quality of evaluation. In combination with the characteristics of Chinese patent medicine and the latest research achievement at home and abroad,the detailed specifications were formulated from six aspects including design,theme selection,content and index,outcome,application and appraisal,and quality control. The guideline was developed based on the guideline development requirements of China Assoication of Chinese medicine. After several rounds of expert consensus and public consultation,the current version of the guideline has been developed.
		                        		
		                        		
		                        		
		                        			Medicine, Chinese Traditional
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		                        			Nonprescription Drugs
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		                        			Consensus
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		                        			China
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		                        			Reference Standards
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		                        			Drugs, Chinese Herbal
		                        			
		                        		
		                        	
9.Comparison of short-term outcomes between fluorescence method versus modified inflation-deflation method on thoracoscopic anatomical segmentectomy: a study based on propensity score matching
Baoming WANG ; Feng WU ; Dongchun MA ; Mingming WANG ; Tangbin LIU ; Congshu HUA ; Chaodong ZHANG ; Wensheng WANG ; Xiang DING ; Jian ZHAO ; Chen DAI
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(3):134-141
		                        		
		                        			
		                        			Objective:To investigate the application value of fluorescence imaging in single-port thoracoscopic anatomic segmentectomy.Methods:The clinical data of 280 patients (145 patients with fluorescence method and 135 patients with modified inflation-deflation method) who underwent thoracoscopic anatomic segmentectomy were retrospectively studied in the Anhui Chest Hospital from June 2020 to June 2021. There were 113 patients in the simple segmentectomy group and 167 patients in the complex segmentectomy group. The baseline data of the fluorescence method and the modified inflation-deflation method in the complex segmentectomy group were corrected by propensity score matching, and the perioperative results were compared between the groups.Results:There were no significant differences in segmental resection time, intraoperative blood loss, postoperative drainage, postoperative pain, postoperative extubation time, length of hospital stay, incidence of complications and cost of hand-holding between the fluorescence method and the modified method of the simple segmentectomy group.In the complex segmentectomy group, the time of segmental resection with the fluorescence method was significantly shorter than that with the modified inflation-deflation method( P<0.05), and other indexes had no significant difference. Conclusion:Fluorescence method single-port thoracoscopic anatomic segmentectomy has the same perioperative safety and short-term efficacy as modified inflation-deflation method, which can significantly shorten the operative time and improve the operative efficiency in complex anatomic segmentectomy.
		                        		
		                        		
		                        		
		                        	
10. Treatment advice of small molecule antiviral drugs for elderly COVID-19
Min PAN ; Shuang CHANG ; Xiao-Xia FENG ; Guang-He FEI ; Jia-Bin LI ; Hua WANG ; Du-Juan XU ; Chang-Hui WANG ; Yan SUN ; Xiao-Yun FAN ; Tian-Jing ZHANG ; Wei WEI ; Ling-Ling ZHANG ; Jim LI ; Fei-Hu CHEN ; Xiao-Ming MENG ; Hong-Mei ZHAO ; Min DAI ; Yi XIANG ; Meng-Shu CAO ; Xiao-Yang CHEN ; Xian-Wei YE ; Xiao-Wen HU ; Ling JIANG ; Yong-Zhong WANG ; Hao LIU ; Hai-Tang XIE ; Ping FANG ; Zhen-Dong QIAN ; Chao TANG ; Gang YANG ; Xiao-Bao TENG ; Chao-Xia QIAN ; Guo-Zheng DING
Chinese Pharmacological Bulletin 2023;39(3):425-430
		                        		
		                        			
		                        			 COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly. 
		                        		
		                        		
		                        		
		                        	
            
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