1.Effect of Icariin on Myocardial Remodeling in Rats Based on Vitamin D Regulation of Dendritic Cell Phenotype
Qian LI ; Yujia CHEN ; Yan ZHOU ; Wen LI ; Liancheng GUAN ; Huanzhen WANG ; Yunzhi CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):76-85
ObjectiveTo investigate the effect of icariin (ICA) on the phenotype of dendritic cells (DCs) in heart tissue of the Dahl salt-sensitive myocardial remodeling model of rats and its regulation on the vitamin D system. MethodsMale Dahl salt-resistant rats were divided into a normal group, and male Dahl salt-sensitive rats were divided into a model group, low-, medium-, and high-dose ICA groups (30, 60, 120 mg·kg-1·d-1), and Vitamin D group (3×10-5 mg·kg-1·d-1). In addition to the normal group, the other groups were given an 8% high salt diet to establish a myocardial remodeling model and received intragastric administration after successful modelling once a day for six weeks. The dynamic changes in tail artery blood pressure were monitored, and detection of cardiac ultrasound function in rats was performed. Hematoxylin-eosin (HE) staining and Masson staining were used to observe the morphological changes in rat heart tissue. The phenotype of DCs and T helper cell 17 (Th17)/regulatory T cell (Treg) ratio were detected by flow cytometry. The mRNA and protein expression of vitamin D receptor (VDR), 1α-hydroxylase (CYP27B1), 24-hydroxylase (CYP24A1), forkhead frame protein 3 (FoxP3), solitaire receptor γt (RORγt), myocardial type Ⅰ collagen (ColⅠ), and type collagen (ColⅢ) in heart tissue was detected by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot. ResultsCompared with the normal group, the model group showed disordered arrangement and rupture of myocardial cells, nuclear condensation, significant edema of myocardial tissue, significant proliferation of collagen fibers in a network distribution, and a significant increase in tail artery blood pressure, left ventricular end diastolic diameter (LVEDD), and left ventricular end systolic diameter (LVESD) (P<0.05). The phenotype of cardiac DCs was CD40, CD80, and CD86, and the levels of major histocompatibility complex Ⅱ (MHC-Ⅱ), Th17 cells, and Th17/Treg were significantly increased (P<0.05). The mRNA and protein expression of CYP24A1 and RORγt in the heart, as well as the mRNA expression of ColⅠ and ColⅢ, were significantly increased (P<0.05). The left ventricular ejection fraction (LVEF), interventricular septal thickness (IVSD), and left ventricular posterior wall thickness (LVPWD) were significantly decreased (P<0.05). The phenotype of cardiac DCs such as CD11, CD11b, and Treg cells, were significantly reduced (P<0.05), while the mRNA and protein expression of cardiac VDR, CYP27B1, and FoxP3 were significantly decreased (P<0.05). Compared with the model group, the low-, medium-, and high-dose ICA groups and vitamin D group significantly reduced myocardial cell rupture and nuclear consolidation in rats. The high-dose ICA group and vitamin D group showed a small amount of myocardial cell rupture and nuclear consolidation, improving myocardial fiber arrangement to varying degrees and significantly reducing myocardial fiber rupture and proliferation. The tail artery blood pressure, LVEDD, and LVESD were significantly decreased in the low-, medium-, and high-dose ICA groups and vitamin D group (P<0.05), and the phenotype of cardiac DCs including CD40, CD80, CD86, MHC-Ⅱ, Th17 cells, and Th17/Treg were significantly decreased (P<0.05). The mRNA and protein expression of CYP24A1 and RORγt, and the mRNA expression of ColⅠ and ColⅢ in the heart were significantly decreased in the medium- and high-dose ICA groups and vitamin D group (P<0.05). The LVEF, IVSD, and LVPWD of myocardial remodeling model rats in the low-, medium-, and high-dose ICA groups and vitamin D group were significantly increased (P<0.05). The phenotypes of cardiac DCs including CD11, CD11b, and Treg cells were significantly increased in the medium- and high-dose ICA groups and the Vitamin D group (P<0.05). The mRNA and protein expressions of VDR, CYP27B1, and FoxP3 in the heart were significantly increased in the medium- and high-dose ICA groups and vitamin D group (P<0.05). ConclusionICA can regulate tail artery blood pressure, cardiac structural and functional damage, and myocardial tissue fibrosis and inhibit phenotype and functional maturation of DCs in heart tissue in the myocardial remodeling model of Dahl salt-sensitive rats. It can also affect the gene and protein expression of VDR, CYP24A1, and CYP27B1, achieving its intervention in Th17/Treg balance in the immune process of myocardial remodeling possibly by regulating vitamin D/VDR in heart tissue.
2.Preparation of polyphenol-mediated copper ion coating on titanium surface and antibacterial and antioxidant properties
Zhenju GUAN ; Yonglin XIE ; Shougang XIANG ; Chengdong ZHANG ; Xiaolong LI ; Xingping LI ; Chao PU ; Bo ZHANG ; Xuwei LUO ; Dongqin XIAO
Chinese Journal of Tissue Engineering Research 2025;29(10):1997-2005
BACKGROUND:Titanium implants are widely used in clinical practice because of their high strength and good biocompatibility.However,during implantation,bacterial infection and tissue damage environment produce a large number of reactive oxygen species,which can easily lead to delayed tissue healing and surgical failure.Consequently,the development of titanium implants with antimicrobial and antioxidant properties becomes paramount. OBJECTIVE:Considering the potent antimicrobial attributes of copper ions and the remarkable antioxidant qualities of polyphenols,we proposed the fabrication of polyphenol-mediated copper ion coatings on titanium surfaces.These coatings were subsequently assessed for their in vitro antimicrobial and antioxidant properties. METHODS:Nanostructures were generated on the titanium surface using the alkali thermal method.The titanium was immersed in a solution containing tannic acid and copper ions to achieve polyphenol-mediated copper ion coatings.The surface morphology and water contact angle were detected.The loading and release of copper ions were examined using atomic absorption spectroscopy.Staphylococcus aureus was inoculated on the surface of pure titanium sheet(blank group),alkali heat treated titanium sheet(control group),and polyphenol mediated copper ion modified titanium sheet(experimental group)to observe the bacterial survival status.Osteoblast precursor cells MC3T3-E1 were co-cultivated on the surface of three groups of titanium sheets to assess their antioxidant properties and bioactivity. RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that the polyphenol-mediated copper ion modified titanium sheet had rod-like nanostructures and no cracks on the surface.The surface hydrophilicity of copper ion modified titanium sheet mediated by polyphenol was close to that of pure titanium sheet.Atomic absorption spectrometry results showed a 51%increase in the loading capacity of copper ions after polyphenol mediation,with a uniform release of copper ions.(2)The antibacterial rates of titanium sheets in the blank group,control group,and experimental group were 0%,21.65%,and 93.75%,respectively.The live/dead staining and CTC staining showed that the live bacteria on the surface of titanium plates in the blank group were the most,and the live bacteria on the surface of titanium plates in the experimental group were the least.(3)The results of live/dead staining and CCK-8 assay showed that the three groups of titanium sheets had good cytocompatibility,and the titanium sheets in the experimental group were more conducive to the proliferation of MC3T3-E1 cells.Active oxygen fluorescence probe detection exhibited that compared with the other two groups,the fluorescence intensity of active oxygen on the surface of the experimental group was significantly reduced.The results of alkaline phosphatase and alizarin red S staining showed that the osteogenic differentiation and extracellular matrix mineralization of MC3T3-E1 cells on the surface of titanium sheets in the experimental group were stronger than those in the other two groups.(4)These results show that the polyphenol-mediated copper ion coating has strong antibacterial and antioxidant properties and promotes osteogenic differentiation.
3.Integrated Optical and Magnetic Navigation for Simplified Percutaneous Transforaminal Endoscopic Lumbar Discectomy: A Novel Approach
Xing-Chen YAO ; Jun-Peng LIU ; Xin-Ru DU ; Li GUAN ; Yong HAI ; Jincai YANG ; Aixing PAN
Neurospine 2025;22(1):297-307
Objective:
This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH).
Methods:
A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups.
Results:
The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05).
Conclusion
This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.
4.Integrated Optical and Magnetic Navigation for Simplified Percutaneous Transforaminal Endoscopic Lumbar Discectomy: A Novel Approach
Xing-Chen YAO ; Jun-Peng LIU ; Xin-Ru DU ; Li GUAN ; Yong HAI ; Jincai YANG ; Aixing PAN
Neurospine 2025;22(1):297-307
Objective:
This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH).
Methods:
A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups.
Results:
The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05).
Conclusion
This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.
5.Study on Graded Quantitative Diagnosis of Lung Qi Deficiency Syndrome in Chronic Obstructive Pulmonary Disease Based on Latent Class Analysis Combined with Hidden Structure Model
Weike LI ; Mingyang YI ; Yuanyuan NI ; Lizhen YAN ; Jianxin GUAN ; Shihao WANG ; Huijie WANG ; Zhiwan WANG
Journal of Traditional Chinese Medicine 2025;66(7):710-716
ObjectiveTo clarify the graded quantitative diagnostic characteristics of lung qi deficiency syndrome in chronic obstructive pulmonary disease (COPD) based on latent class analysis combined with a hidden structure model. MethodsClinical data, including the four diagnostic methods of traditional Chinese medicine (TCM), were collected from 745 COPD patients with lung qi deficiency syndrome. Latent class modeling was performed using R 4.1.2 software, and each patient was classified into one of three severity categories (mild, moderate, or severe) based on probabilistic parameterization, parameter estimation, and model fitting. A database was established for different severity levels of lung qi deficiency syndrome. Based on this, Lantern 5.0 software was used to construct hidden structure models for mild, moderate, and severe lung qi deficiency syndrome, and syndrome differentiation rules were developed through comprehensive clustering. ResultsA latent class model was constructed using 28 symptoms and signs with a frequency greater than 10%. Considering TCM theory and model simplicity, the optimal model was determined when the number of latent classes was three, categorizing lung qi deficiency syndrome into mild (298 cases), moderate (164 cases), and severe (283 cases). Hidden structure models were separately developed for each severity level, and syndrome differentiation rules were established. A comparison of common symptoms in the syndrome differentiation rules for mild and moderate lung qi deficiency syndrome showed no statistically significant differences in diagnostic values and weights (P>0.05), leading to their combined analysis and the development of a unified syndrome differentiation rule. Value and weight of quantitative diagnosis of mild-to-moderate lung qi deficiency syndrome were as followed: shortness of breath (diagnostic value 9.3, diagnostic weight 86.92%), dyspnea on exertion (8.2, 76.64%), low voice and reluctance to speak (6.7, 62.62%), poor appetite (4.0, 37.38%), loose stools (4.0, 37.38%), weak cough sound (2.9, 27.10%), wheezing (2.3, 21.50%), fatigue (1.8, 16.82%), spontaneous sweating (1.7, 15.89%), susceptibility to colds (1.6, 14.95%), swollen tongue (1.4, 13.08%), teeth marks on the tongue edge (1.2, 11.21%), deep pulse (1.6, 14.95%), with a diagnostic threshold of 10.3. Value and weight of quantitative diagnosis of severe lung qi deficiency syndrome were as followed: weak cough sound (15.1, 61.13%), soreness and weakness of the waist and knees (12.6, 51.01%), shortness of breath (11.1, 44.94%), low voice and reluctance to speak (8.3, 33.60%), frequent nocturia (6.1, 24.70%), spontaneous sweating (3.7, 14.98%), susceptibility to colds (3.5, 14.17%), teeth marks on the tongue edge (7.8, 31.58%), pale tongue body (1.9, 7.69%), white tongue coating (5.5, 22.27%), thin pulse (1.5, 6.07%), with a diagnostic threshold of 23.7. ConclusionThe combination of latent class analysis and a hideen structure model effectively clarified the graded quantitative diagnostic characteristics of lung qi deficiency syndrome, providing a reference for the quantitative diagnosis of other fundamental syndromes in TCM.
6.Study on the mechanism of Danggui buxue decoction regulating neutrophil extracellular traps to improve osteo-porosis in rats with premature ovarian failure
Chuiqiao HUANG ; Shuai CHEN ; Qian LI ; Liancheng GUAN ; Jie GAO ; Zhong QIN ; Yunzhi CHEN
China Pharmacy 2025;36(6):655-660
OBJECTIVE To investigate the mechanism through which Danggui buxue decoction regulates neutrophil extracellular traps (NETs) to improve osteoporosis (OP) in rats with premature ovarian failure (POF). METHODS Female SD rats were randomly divided into normal group, model group, calcitriol group, and Danggui buxue decoction low-dose, medium-dose and high-dose groups, with 9 rats in each group. Except for the normal group, all other groups were administered cisplatin via intraperitoneal injection on days 1 and 8 to establish a POF complicated with OP model. Each group received the corresponding drugs or normal saline intragastrically starting from day 5, once a day, for 4 consecutive weeks. After the last medication, serum levels of estradiol (E2), NETs, 25-hydroxyvitamin D3 [25(OH)D3], receptor activator of nuclear factor-κB ligand (RANKL), and osteocalcin (BGP) were measured. The histopathological changes in bone tissue were observed. The expressions of vitamin D receptor (VDR), myeloperoxidase (MPO), neutrophil elastase (NE) and citrullinated histone H3 (CitH3) in bone tissue were detected; the protein expressions of 25-hydroxyvitamin D-1α-hydroxylase (CYP27B1) and 1α,25-dihydroxyvitamin D3-24-hydroxylase (CYP24A1) were also determined. RESULTS Compared with the normal group, the bone tissue of rats in the model group showed a significant reduction in the number of trabeculae, which was thinner broken and poorly connected, with significant destruction of the reticular structure, and an enlarged marrow cavity. Serum levels of NETs and RANKL, the protein expressions of MPO, NE, CitH3 and CYP24A1 in bone tissue were significantly increased or upregulated, while serum levels of E2, 25(OH)D3 and BGP as well as protein expressions of VDR and CYP27B1 were significantly decreased or downregulated (P<0.05). Compared with the model group, the histopathological changes in the bone tissue of rats in each administration group showed some degree of recovery, with significant improvements observed in most quantitative indicators (P<0.05). CONCLUSIONS Danggui buxue decoction can restore the E2 level in POF complicated with OP rats, and improve OP. The mechanism may be related to its ability to upregulate VD level and inhibit the formation of NETs.
7.Changes in the body shape and ergonomic compatibility for functional dimensions of desks and chairs for students in Harbin during 2010-2024
Chinese Journal of School Health 2025;46(3):315-320
Objective:
To analyze the change trends in the body shape indicators and proportions of students in Harbin from 2010 to 2024, and to investigate ergonomic compatibility of functional dimensions of school desks and chairs with current student shape indicators, so as to provide a reference for revising furniture standards of desks and chairs.
Methods:
Between September and November of both 2010 and 2024, a combination of convenience sampling and stratified cluster random sampling was conducted across three districts in Harbin, yielding samples of 6 590 and 6 252 students, respectively. Anthropometric shape indicators cluding height, sitting height, crus length, and thigh length-and their proportional changes were compared over the 15-year period. The 2024 data were compared with current standard functional dimensions of school furniture. The statistical analysis incorporated t-test and Mann-Whitney U- test.
Results:
From 2010 to 2024, average height increased by 1.8 cm for boys and 1.5 cm for girls; sitting height increased by 1.5 cm for both genders; crus length increased by 0.3 cm for boys and 0.4 cm for girls; and thigh length increased by 0.5 cm for both genders. The ratios of sitting height to height, and sitting height to leg length increased by less than 0.1 . The difference between desk chair height and 1/3 sitting height ranged from 0.4-0.8 cm. Among students matched with size 0 desks and chairs, 22.0% had a desk to chair height difference less than 0, indicating that the desk to chair height difference might be insufficient for taller students. The differences between seat height and fibular height ranged from -1.4 to 1.1 cm; and the differences between seat depth and buttock popliteal length ranged from -9.8 to 3.4 cm. Among obese students, the differences between seat width and 1/2 hip circumference ranged from -20.5 to -8.7 cm, while it ranged from -12.2 to -3.8 cm among non obese students.
Conclusion
Current furniture standards basically satisfy hygienic requirements; however, in the case of exceptionally tall and obese students, ergonomic accommodations such as adaptive seating allocation or personalized adjustments are recommended to meet hygienic requirements.
8.Effects of peiminine B on Streptococcus pneumoniae-induced alveolar epithelial cell injury and its mechanism
Rui ZHANG ; Cuihong LI ; Youqin WANG ; Junyan GUAN
China Pharmacy 2025;36(7):820-825
OBJECTIVE To investigate the effects of peiminine B (PEI) on Streptococcus pneumoniae (SP)-induced alveolar epithelial cell injury by regulating the Ras-related C3 botulinum toxin substrate 1 in nucleus accumbens (Rac1)/protein kinase B (Akt)/nuclear factor κB (NF-κB) signaling pathway. METHODS Human alveolar epithelial cells (HPAEpiC) were taken and randomly divided into the Control group, SP group (1×108 cfu/mL SP bacterial solution), low-, medium-, and high-concentration PEI groups (1×108 cfu/mL SP bacterial solution+0.05, 0.10, 0.20 mmol/L PEI), and high-concentration PEI+Akt activator group (P-H+SC79 group, 1×108 cfu/mL SP bacterial solution+0.20 mmol/L PEI+10 μmol/L SC79). Except for the Control group, the other groups of cells were treated with SP bacterial solution and/or corresponding drug solution. After 24 h of treatment, the levels of inflammatory factors (interleukin-6, -18, -1β) in the supernatant solution, the contents of oxidative stress indexes [lactate dehydrogenase (LDH), reactive oxygen species (ROS) and superoxide dismutase (SOD)], apoptosis rate, as well as the expressions of proliferation/apoptosis-related proteins [cyclin-dependent kinase 1 (CDK1), B cell lymphoma-2 related X protein (Bax)] and pathway-related proteins (Rac1, Akt, phosphorylated Akt, NF-κB and phosphorylated NF-κB) were detected in each group. RESULTS Compared with the Control group, the levels of inflammatory factors in supernatant solution, LDH and ROS contents, apoptosis rate, the protein expressions of Bax and Rac1 and the phosphorylation levels of Akt and NF-κB in the SP group were significantly increased or up-regulated, while SOD content and the protein expression of CDK1 were significantly decreased or down-regulated (P<0.05). Compared with the SP group, the above indexes in PEI groups were significantly improved in a concentration-dependent manner (P<0.05). SC79 could significantly reverse the improvement effect of the high concentration of PEI (P<0.05). CONCLUSIONS PEI can alleviate SP-induced inflammation and oxidative stress damage of alveolar epithelial cells and inhibit apoptosis, which may be achieved by inhibiting Rac1/Akt/NF-κB signaling pathway.
9.Structural and Spatial Analysis of The Recognition Relationship Between Influenza A Virus Neuraminidase Antigenic Epitopes and Antibodies
Zheng ZHU ; Zheng-Shan CHEN ; Guan-Ying ZHANG ; Ting FANG ; Pu FAN ; Lei BI ; Yue CUI ; Ze-Ya LI ; Chun-Yi SU ; Xiang-Yang CHI ; Chang-Ming YU
Progress in Biochemistry and Biophysics 2025;52(4):957-969
ObjectiveThis study leverages structural data from antigen-antibody complexes of the influenza A virus neuraminidase (NA) protein to investigate the spatial recognition relationship between the antigenic epitopes and antibody paratopes. MethodsStructural data on NA protein antigen-antibody complexes were comprehensively collected from the SAbDab database, and processed to obtain the amino acid sequences and spatial distribution information on antigenic epitopes and corresponding antibody paratopes. Statistical analysis was conducted on the antibody sequences, frequency of use of genes, amino acid preferences, and the lengths of complementarity determining regions (CDR). Epitope hotspots for antibody binding were analyzed, and the spatial structural similarity of antibody paratopes was calculated and subjected to clustering, which allowed for a comprehensively exploration of the spatial recognition relationship between antigenic epitopes and antibodies. The specificity of antibodies targeting different antigenic epitope clusters was further validated through bio-layer interferometry (BLI) experiments. ResultsThe collected data revealed that the antigen-antibody complex structure data of influenza A virus NA protein in SAbDab database were mainly from H3N2, H7N9 and H1N1 subtypes. The hotspot regions of antigen epitopes were primarily located around the catalytic active site. The antibodies used for structural analysis were primarily derived from human and murine sources. Among murine antibodies, the most frequently used V-J gene combination was IGHV1-12*01/IGHJ2*01, while for human antibodies, the most common combination was IGHV1-69*01/IGHJ6*01. There were significant differences in the lengths and usage preferences of heavy chain CDR amino acids between antibodies that bind within the catalytic active site and those that bind to regions outside the catalytic active site. The results revealed that structurally similar antibodies could recognize the same epitopes, indicating a specific spatial recognition between antibody and antigen epitopes. Structural overlap in the binding regions was observed for antibodies with similar paratope structures, and the competitive binding of these antibodies to the epitope was confirmed through BLI experiments. ConclusionThe antigen epitopes of NA protein mainly ditributed around the catalytic active site and its surrounding loops. Spatial complementarity and electrostatic interactions play crucial roles in the recognition and binding of antibodies to antigenic epitopes in the catalytic region. There existed a spatial recognition relationship between antigens and antibodies that was independent of the uniqueness of antibody sequences, which means that antibodies with different sequences could potentially form similar local spatial structures and recognize the same epitopes.
10.Overview of systematic evaluation of anti-VEGF drugs in the treatment of diabetic macular oedema
Jingnan GUAN ; ZONGYONGYANGCUO ; Juan LING ; Xianyan SHEN ; Menghan LI ; Xufan CHEN ; Yonglin LIANG ; Dinghua ZHANG
China Pharmacy 2025;36(8):996-1000
OBJECTIVE To re-evaluate the use of systematic evaluation/meta-analysis of anti-VEGF drugs in the treatment of diabetic macular oedema (DME), aiming to provide evidence-based support for the clinical application of this medication. METHODS A comprehensive search was conducted across a range of databases, including CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library. The objective was to identify systematic evaluation/meta-analysis of anti- VEGF drugs for DME, with search time from the inception of the databases to March 2024. The report quality, methodological quality, and evidence quality were assessed by using PRISMA2020 statement, AMSTAR2 scale and GRADE tool. A comprehensive analysis of systematic evaluation/meta-analysis results was also conducted. RESULTS A total of 22 articles were included. According to the PRISMA2020 statement evaluation, 13 studies provided relatively complete information (≥21 points), while 9 studies had information deficiencies (18-<21 points). The AMSTAR 2 scale evaluation revealed that 21 studies had very low methodological quality, and one study had low methodological quality. The GRADE tool evaluation showed that out of 89 outcome indicators, 28( 31.46%) were classified as high-quality evidence, 34( 38.20%) as moderate-quality evidence, 24( 26.97%) as low- quality evidence, and 3 (3.37%) as very low-quality evidence. The comprehensive quality analysis results demonstrated that, compared with laser photocoagulation, anti-VEGF drugs significantly enhanced the improvement in best-corrected visual acuity (BCVA), as well as significant change in retinal thickness at 1 and 6 months, and 1 and 2 years post-treatment, and also in BCVA and retinal thickness at 1, 3, and 6 months post-treatment (P<0.05). Compared with placebo, patients treated with anti-VEGF drugs showed significant improvement in BCVA after 1 year of treatment (P<0.05). However, when compared with corticosteroid drugs, patients treated with anti-VEGF drugs exhibited a significant increase in retinal thickness after 6 months of treatment (P<0.05). Compared with corticosteroid drugs, the incidence of adverse events related to the eyes, cataract formation and intraocular pressure were significantly decreased in patients treated with anti-VEGF drugs (P<0.05). Compared with laser photocoagulation, the incidence of ocular adverse events was significantly decreased in patients treated with anti-VEGF drugs, while the incidence of fatal adverse events was significantly increased (P<0.05). CONCLUSIONS Anti-VEGF therapy for DME may possess certain advantages in terms of efficacy and safety, but it is associated with a higher risk of fatal adverse events; the evidence included in systematic reviews/meta-analyses is of moderate to high quality.


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