1.Interpretation of Reporting Items for Practice Guidelines in Healthcare for Chinese Patent Medicines (RIGHT for CPM)
Liaoyao WANG ; Hejing PAN ; Le ZHANG ; Wenya WANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):211-218
The clinical practice guidelines for Chinese patent medicines (CPM) provide reference for the selection of national drug catalogs, the formulation of prescription collections in medical institutions, and the clinical use of CPM, constituting an important part of traditional Chinese medicine (TCM) guidelines. As a crucial part of Chinese drug supply guarantee system, CPM plays an important role in the treatment, prevention, and healthcare of many disease categories, whereas the application of CPM has problems of misuse and even abuse. To standardize the application of CPM, a research team at Zhejiang Chinese Medical University developed the Reporting Items for Practice Guidelines in Healthcare for Chinese Patent Medicines (RIGHT for CPM) based on the RIGHT checklist framework. The RIGHT for CPM checklist gathers key information from published CPM guidelines, existing TCM reporting checklists, and the RIGHT checklist and its extensions to form an initial pool of reporting items. Seventeen experts from different disciplines were invited to conduct two rounds of Delphi surveys, and the final checklist was reviewed and approved for publication by 18 leading experts in TCM research and guideline reporting from China and abroad. The RIGHT for CPM checklist adds 16 sub-items and revises 2 sub-items on the basis of the RIGHT checklist, highlighting the characteristics of CPM guideline reporting. It considers CPM selection and inclusion criteria, policy access, indications and symptoms, drug combination instructions, drug use in special populations, precautions, and recommendations of Western medical physicians, among others. This can further improve the quality and transparency of CPM guideline reporting, promote standardized reporting of CPM guidelines, and facilitate the rational clinical use of CPM. This article interprets the development process of the RIGHT for CPM checklist and the items that highlight the characteristics of CPM guidelines, with a view to promoting the application of the RIGHT for CPM checklist.
2.Comparison of myopia progression before and after discontinuation of low-concentration atropine in children wearing orthokeratology lenses
Yaozeng WANG ; Pan LI ; Jin WANG ; Zikang LU
International Eye Science 2025;25(1):134-139
AIM: To compare the progression of myopia in children wearing orthokeratology lenses combined with low-concentration atropine before and after drug withdrawal, to determine the rebound effect of drug withdrawal in orthokeratology lens wearers, and to analyze its causes based on changes in pupil diameter.METHODS:A prospective case-control study was conducted to collect 80 children with myopia who were treated with orthokeratology lenses combined with 0.01% atropine ophthalmic gel at the Xi'an No.1 Hospital from January to June 2022. One year later, they were divided into a drug withdrawal group(Group A, 40 cases)and a continuous medication group(Group B, 40 cases)based on whether they stopped taking the medication. The progression of myopia before and after drug withdrawal was observed by analyzing changes in axial length(AL)and spherical equivalent(SE)in the group A within 1 a before and after drug withdrawal. The changes in AL, pupil diameter(PD), and SE were compared between the group A and group B within 2 a, and the correlation between PD and AL growth was analyzed.RESULTS:In the group A, the AL increased by 0.17±0.23 and 0.29±0.18 mm at 0.5 and 1 a after drug withdrawal, respectively, which were both greater than before drug withdrawal(t=5.318, 2.983, both P<0.001). There was no statistically significant difference in SE growth between the two time points(P>0.05). There were no statistically significant differences in AL and PD between the group A and group B at baseline, 0.5 and 1 a during combined medication(all P>0.05). At 1.5 a, the AL growth of the group A was greater than that of the group B(0.32±0.27 mm vs 0.26±0.20 mm, t=7.363, P<0.001), and the PD was smaller than that of the group B(3.60±1.25 mm vs 4.12±1.92 mm, t=-7.541, P<0.001). At 2 a, the AL growth of the group A was greater than that of the group B(0.44±0.18 mm vs 0.32±0.14 mm, t=5.709, P<0.001), and the PD was smaller than that of the group B(3.67±1.31 mm vs 4.02±1.67 mm, t=-4.281, P<0.001). Correlation analysis showed a negative correlation between PD and AL growth at 0.5 and 1 a follow-ups over 2 a(R2=-0.156, -0.190, both P<0.001).CONCLUSION: After stopping low-concentration atropine in children wearing orthokeratology lenses, AL increased more rapidly than before drug withdrawal, PD decreased, and SE changed little. Compared with continuous medication, discontinuation of medication led to faster progression of AL with little change in diopter, and the larger the PD during orthokeratology lens wear, the slower the progression of AL.
3.Dipsacus asper Treats Alzheimer's Disease in Caenorhabditis elegans by Regulating PPARα/TFEB Pathway
Mengmeng WANG ; Jianping ZHAO ; Limin WU ; Shuang CHU ; Yanli HUANG ; Zhenghao CUI ; Yiran SUN ; Pan WANG ; Hui WANG ; Zhenqiang ZHANG ; Zhishen XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):104-114
ObjectiveTo investigate the anti-Alzheimer's disease (AD) effect of Dipsacus asper(DA) in the Caenorhabditis elegans model, and decipher the underlying mechanism via the peroxisome proliferator-activated receptor α (PPARα)/transcription factor EB (TFEB) pathway. MethodsFirst, transgenic AD C. elegans individuals were assigned into the blank control, model, positive control (WY14643, 20 µmol·L-1), and low-, medium-, and high-dose (100, 200, and 400 mg·L-1, respectively) DA groups. The amyloid β-42 (Aβ42) formation in the muscle cells, the paralysis time, and the deposition of amyloid β-protein (Aβ) in the head were detected. The lysosomal autophagy in the BV2 cell model was examined by Rluc-LC3wt/G120A. The expression levels of lysosomal autophagy-related proteins LC3Ⅱ, LC3I, LAMP2, and TFEB were detected by Western blot. Real-time quantitative polymerase chain reaction (Real-time PCR) was employed to determine the mRNA levels of autophagy-related genes beclin1 and Atg5 and lysosome-related genes LAMP2 and CLN2 downstream of PPARα/TFEB. A reporter gene assay was used to detect the transcriptional activities of PPARα and TFEB. Immunofluorescence was used to detect the fluorescence intensity of PPARα, and the active components of the ethanol extract of DA were identified by UPLC-MS. RCSB PDB, Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and Autodock were used to analyze the binding between the active components and PPARα-ligand-binding domain (LBD). ResultsCompared with the model group, the positive control group and 200 and 400 mg·L-1 DA groups showed prolonged paralysis time (P<0.05), and all the treatment groups showed decreased Aβ deposition in the head (P<0.01). DA within the concentration range of 50-500 mg·L-1 did not affect the viability of BV2 cells. In addition, DA enhanced the autophagy flux (P<0.05), up-regulated the mRNA levels of beclin1, Atg5, LAMP2, and CLN2 (P<0.05, P<0.01), promoted the nuclear translocation of TFEB (P<0.05), increased LAMP2 expression and autophagy flux (P<0.05, P<0.01), and enhanced the transcriptional activities of PPARα and TFEB (P<0.01). The positive control group and 200 and 400 mg·L-1 DA groups showed enhanced fluorescence intensity of PPARα in the BV2 nucleus (P<0.01). UPLC-MS detected nine known compounds of DA, from which 8 active components of DA were screened out. The docking results suggested that a variety of components in DA could bind to PPARα-LBD and form stable hydrogen bonds. ConclusionDA may reduce the pathological changes in AD by regulating the PPARα-TFEB pathway.
4.Molecular epidemiological investigations of human parvovirus B19 among blood donors in Lanzhou
Kangle WU ; Shulong YANG ; Weiping FENG ; Weirong WANG ; Deng PAN
Chinese Journal of Blood Transfusion 2025;38(1):68-72
[Objective] To investigate the molecular prevalence and genotype of human parvovirus B19(B19) among blood donors in Lanzhou, and provide data support for monitoring the positive rate of B19 DNA in local blood donors. [Methods] A total of 7 644 blood donor samples collected from January to September 2022 were randomly screened using real-time fluorescent PCR, resulting in 23 samples testing positive for B19 DNA. The characteristics of the B19 DNA reactive donors including gender, age, blood donation recruitment and promotion mode, and donation frequency were analyzed using SPSS 22.0. Additionally, the VP1 gene fragment of B19 DNA reactive samples was sequenced and an evolutionary tree was constructed by the N-J method. [Results] The results showed that the positive rate of B19 DNA in Lanzhou was 0.30%, and the positive population mainly consisted of female individuals aged 18-30 years old who were first-time blood donors; furthermore, genotype 1a was identified as predominant. [Conclusion] The positive rate of B19 DNA is low among blood donors in Lanzhou, with genotype 1a being predominant. It is recommended to periodically monitor the B19 prevalence in blood donors and enhance prevention and control measures, thus improving blood quality and safety.
5.Risk Factors and Nomogram Prediction Model for Iron Deficiency Anemia in Late Pregnancy
Lin YANG ; Yixiong WANG ; Hui PAN ; Yang XU
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(1):116-122
ObjectiveThis study aims to identify potential risk factors, establish a nomogram prediction model and propose intervention strategies for iron deficiency anemia (IDA) in late pregnancy. MethodsQuestionnaire surveys and routine blood tests were performed on pregnant women who received regular antenatal check-ups at Yangzhou Maternal and Child Health Hospital from July 2022 to December 2023. Of the 500 cases enrolled, 482 completed the trial and were divided into IDA and non-IDA groups based on the presence of IDA in the third trimester. Univariate analysis and multivariate logistic regression were employed to identify risk factors for IDA, while R software was used to construct a nomogram prediction model. ResultsThe incidence of IDA in late pregnancy was 19.92% (96/482). Univariate analysis revealed significant associations between IDA in late pregnancy and factors such as economic independence, preconception body mass index (BMI), number of pregnancies, and regular iron supplementation during pregnancy (P<0.05). Multivariate logistic regression showed that economic independence (P=0.031, OR=0.583) and regular iron supplementation during pregnancy (P<0.001, OR=5.337) were protective factors against IDA. Conversely, a low preconception BMI (P=0.021, OR=2.375) and three or more pregnancies (P=0.015, OR=2.253) emerged as significant risk factors. The receiver operating characteristic (ROC) curve analysis demonstrated that the area under the curve (AUC) for the nomogram predicting IDA was 0.84, with an optimal cutoff value of -1.481, a sensitivity of 81.2% and a specificity of 75.1%. ConclusionsThe incidence of IDA in late pregnancy is quite high. A low preconception BMI and three or more pregnancies are risk factors, while economic independence and regular iron supplementation are protective factors. These insights have enabled the construction of a prediction model, which, in turn, could provide guidance for prediction and treatment of IDA in late pregnancy.
6.Analysis of depressive symptoms and associated factors among primary and secondary school students in the in depth monitoring counties Rural Nutrition Improvement Program
Chinese Journal of School Health 2025;46(2):219-222
Objective:
To understand the prevalence and related factors of depressive symptoms among primary and secondary school students in the in depth monitoring counties of China s Rural Compulsory Education Nutrition Improvement Program, so as to provide a basis for prevention and psychological intervention of depressive symptoms among children and adolescents in rural areas.
Methods:
In November 2022, a stratified random sampling method was adopted to collect height and weight data, basic personal and family information of 7 949 primary and secondary school students from grade three to grade nine through physical measurements and questionnaires in 56 key monitoring schools implementing the Student Nutrition Improvement Program in 7 in depth monitoring counties (Jalaid Banner in Inner Mongolia, Jinzhai County in Anhui, Mao Xian in Sichuan, Tiandeng County in Guangxi, Mian County in Shaanxi, Zhaozhou County in Heilongjiang and Youxi County in Fujian), and to obtain the information related to their depressive symptoms through the self assessment questionnaire on depression. Multivariate Logistic regression analysis was conducted to analyze the prevalence of depressive symptoms among primary and secondary school students, as well as their related factors.
Results:
The detection rate of depressive symptoms among primary and secondary school students in the in depth monitored counties was 23.5%. Logistic regression analysis showed that the probability of detecting depressive symptoms was higher among female students, middle school students, students whose video screen duration per day was >2 h, and students whose parents marital status was divorced or widowed ( OR =1.40, 1.64, 1.60, 1.24), and students whose sleep duration reached the recommended standard, whose parents usually accompanied them daily for time was 60-<120 min and ≥120 min, and students whose mothers literacy level was middle school graduation had lower probability of detecting depressive symptoms ( OR =0.85, 0.84, 0.71, 0.76) ( P < 0.05 ).
Conclusion
The detection rate of depressive symptoms among students in the in depth monitoring area is high, and targeted interventions need to be developed for students to reduce the risk of mental health problems.
7.Spatio-temporal clustering analysis of mumps in Wenzhou City from 2010 to 2023
LI Ling ; WEI Jingjiao ; PAN Qiongjiao ; LI Wancang ; WANG Jian
Journal of Preventive Medicine 2025;37(3):284-287
Objective:
To identify the spatio-temporal clustering analysis of mumps in Wenzhou City, Zhejiang Province from 2010 to 2023, so as to provide the basis for improving mumps prevention and control strategies.
Methods:
Data of mumps cases in Wenzhou City from 2010 to 2023 were collected from the Monitoring and Reporting Management System of Chinese Disease Prevention and Control Information System. The spatio-temporal clustering characteristics of mumps incidence were identified using spatial autocorrelation analysis and spatio-temporal scan analysis.
Results:
A total of 20 455 mumps cases were reported in Wenzhou City from 2010 to 2023, with an average annual incidence of 17.54/105. There were 12 919 male and 7 536 female cases, with a male-to-female ratio of 1.71∶1. The children aged 5-<10 years had the highest incidence of mumps at 135.29/105. The incidence of mumps showed a downward trend from 46.82/105 in 2010 to 3.59/105 in 2023 (P<0.05). The incidence of mumps peaked from May to July and from November to January during 2010 and 2012, the winter peak became less evident after 2013, and no seasonal trends were observed after 2020. Spatial autocorrelation analysis showed there was a positive spatial correlation of mumps of other years, with the exception of 2018 (all Moran's I >0, all P<0.05). Lucheng District, Longwan District, Ouhai District, Cangnan County and Rui'an City were high-high clustering sites. Spatio-temporal scan analysis showed that the primary clustering area was centered in Nanbaixiang Street, Ouhai District, covering 50 towns (streets), with the clustering time from April 2010 to August 2013; the secondary clustering area was centered in Zaoxi Town, Cangnan County, covering 24 towns (streets), with the clustering time from January 2010 to June 2013.
Conclusions
The incidence of mumps in Wenzhou City from 2010 to 2023 showed a downward trend. The urban areas, Cangnan County and Rui'an City were the clustering areas.
8.Study on the improvement effects of Compound qinbai granules on ulcerative colitis in rats and its mechanism
Shouyan HE ; Wenpeng LUO ; Liao PAN ; Jinyin XIAO ; Zhenquan WANG
China Pharmacy 2025;36(6):686-691
OBJECTIVE To investigate the improvement effects of Compound qinbai granules on ulcerative colitis (UC) in rats and its mechanism based on short-chain fatty acid (SCFA) and their targets G protein-coupled receptor (GPR). METHODS Male SD rats were randomly divided into normal group (12 rats) and model group (30 rats); the model group was given 5% dextran sulfate sodium solution to induce the UC model. Model rats were divided into the model group, positive control group [Mesalazine enteric-coated tablets 270 mg/(kg·d)] and Compound qinbai granules group [2.52 g/(kg·d)], with 9 rats in each group. Rats in each group were orally administered with normal saline or corresponding medication twice a day, for three consecutive weeks. During intragastric administration, the general conditions of rats in each group were observed, and the disease activity index (DAI) scores were assessed after the last administration. Serum levels of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin-6) and anti-inflammatory cytokines (transforming growth factor-β1, interleukin-10) were measured. Pathological changes in their colonic tissues were observed and scored. Additionally, the content of SCFA (acetic acid, propionic acid and butyric acid) in their feces as well as the protein and mRNA expressions of GPR41, GPR43 and GPR109A in colonic tissues were detected. RESULTS Compared with the normal group, rats in the model group exhibited lethargy and obvious blood in their feces; the colonic tissue structure was severely damaged, with pathological changes such as notable glandular loss, edema, and inflammatory cell infiltration visible; the serum levels of pro- inflammatory cytokines, DAI score and colonic pathology score were significantly increased, while the levels of anti-inflammatory cytokines, SCFA content, and protein and mRNA expressions of GPR41, GPR43 and GPR109A were significantly decreased or down-regulated (P<0.01). Compared with the model group, the general condition and pathological changes of colonic tissue in each administration group showed improvement, with significant reversal observed in the aforementioned quantitative indicators (P<0.05 or P<0.01). CONCLUSIONS Compound qinbai granules can alleviate intestinal inflammation and intestinal mucosal damage in UC rats. These effects may be related to its ability to restore intestinal SCFA levels and the expression of their target GPR.
9.Effect of Modified Chaihu Shugansan on CaMKⅡ/CREB Signaling Pathway in Rats with Myocardial Ischemia and Depression
Fen WAN ; Xiaohong LI ; Ying CHEN ; Yangyu PAN ; Yanna LUO ; Fangge LU ; Chuncheng ZHENG ; Pengyun KONG ; Chengxiang WANG ; Liqiang YANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):1-11
ObjectiveTo observe the effects of modified Chaihu Shugansan on the calmodulin-dependent protein kinase Ⅱ(CaMKⅡ)/cAMP-response element binding protein (CREB) signaling pathway in the hippocampus and heart tissue of a rat model with myocardial ischemia and depression and explore the mechanism by which this formula prevents and treats coronary heart disease combined with depression. MethodsThe model of myocardial ischemia combined with depression was established by high-fat diet, intraperitoneal injection of isoproterenol (ISO), and chronic unpredictable mild stress (CUMS). A total of 108 SD male rats were randomly divided into normal group, model group, high (23.4 g·kg-1), medium (11.7 g·kg-1), and low (5.85 g·kg-1) dose groups of modified Chaihu Shugansan, CaMKⅡ inhibitor (KN93) group, and KN93 + high, medium, and low dose groups of modified Chaihu Shugansan, with 12 rats in each group. From the first day of modeling to the end of modeling, drugs were administered once a day. In the seventh and eighth weeks, the KN93 group and the KN93 + high, medium, and low dose groups of modified Chaihu Shugansan were intraperitoneally injected with KN93 three times weekly. At the end of the eighth week, behavioral tests including sucrose preference, open field, and elevated plus maze were conducted. Electrocardiogram (ECG) lead Ⅱ changes were observed in each group of rats, and hematoxylin-eosin (HE) staining was performed to observe changes in heart tissue. Serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and lactate dehydrogenase (LDH) were measured by using an enzyme-labeled instrument. Creatine kinase (CK) and creatine kinase-MB (CK-MB) were detected by ultraviolet spectrophotometry, while serum monocyte chemoattractant protein-1 (MCP-1) was measured by enzyme-linked immunosorbent assay (ELISA). Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect mRNA expression of CaMKⅡ and CREB in hippocampal and heart tissue, and Western blot was performed to assess protein expression of CaMKⅡ, phosphorylated (p)-CaMKⅡ, CREB, and p-CREB. ResultsCompared to the normal group, the model group showed significant reductions in sucrose preference rate, total activity distance in the open field, number of entries into the center area of the open field, and percentage of entries into the open arms of the elevated plus maze (P<0.01). The ECG showed ST-segment elevation, and HE staining showed serious degeneration of myocardial fibers, disordered arrangement, and infiltration of a large number of inflammatory cells. In addition, serum TC and LDL levels increased (P<0.01), and HDL level decreased (P<0.01). CK, CK-MB, LDH, and MCP-1 levels significantly increased (P<0.05, P<0.01). The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB decreased in the hippocampal tissue (P<0.05, P<0.01), but those increased in the heart tissue (P<0.01). Compared to the model group, the high, medium, and low dose groups of modified Chaihu Shugansan showed improvements in these abnormalities. The KN93 group had reduced sucrose preference, total activity distance in the open field, number of entries into the center area of the open field, and percentage of entries into the open arms of the elevated plus maze (P<0.01), as well as decreased serum CK, CK-MB, LDH, and MCP-1 levels (P<0.05, P<0.01). KN93 also reduced ST-segment elevation, alleviated the degeneration degree of myocardial fibrosis, and lowered inflammatory cell infiltration. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB in both the hippocampal and heart tissue were reduced (P<0.05, P<0.01). The KN93 + high, medium, and low dose groups of modified Chaihu Shugansan showed further improvements in these abnormalities compared to the KN93 group. ConclusionThe modified Chaihu Shugansan exerts antidepressant and myocardial protective effects in rats with myocardial ischemia and depression, possibly related to bidirectional regulation of the CaMKⅡ/CREB signaling pathway, with the high-dose modified Chaihu Shugansan showing the best effects.
10.Epidemiological investigation and post-natal follow-up analysis of hepatitis B exposed children in Wenzhou area
Lulu PAN ; Jianle SUN ; Qian XU ; Enshu WANG
Journal of Public Health and Preventive Medicine 2025;36(2):131-134
Objective To investigate the situation of hepatitis B immune blocking and the growth and development of hepatitis B exposed children within one year after birth, and to provide evidence for formulating and optimizing measures for maternal and infant blocking in Wenzhou. Methods The hepatitis B infection status during pregnancy and birth was collected, hepatitis B immunoglobulin and vaccine were analyzed, and a follow-up on the immune blocking effect, growth and development, and the nutritional status of children exposed to hepatitis B was conducted. Statistical analysis of data was carried out through SPSS 26.0. Results In 2021, 6.07% of newborns in Wenzhou were exposed to hepatitis B, of which 28.37% were highly exposed children. The prevalence rates for males and females were 6.42% and 5.70%, respectively, and the difference was statistically significant (χ2=13.744, P<0.001). The prevalence rates in mountainous and non-mountainous counties were 6.35% and 5.94%, respectively, and the difference was statistically significant (χ2=5.72, P < 0.001). In 2021, the mother-to-child transmission rate of children exposed to hepatitis B was 0.54‰. There were no significant differences in the height, weight, hemoglobin and neuropsychological development of hepatitis B exposed children compared with non-exposed children (P < 0.001). Conclusion The number of children exposed to hepatitis B in mountainous counties is significantly higher than that in non-mountainous counties in Wenzhou, and the number of men is significantly higher than that of women. The proportion of highly exposed children is relatively high. The effect of mother-to-child blocking is good, and there is no significant difference between the growth and development of children exposed to hepatitis B and no-exposed children during follow-up.


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