1.Clinical Application of Green Prescription of Traditional Chinese Medicine:Problems and Solution Strategies
Yike SONG ; Zhijun BU ; Wenxin MA ; Kai LIU ; Yuyi WANG ; Yuan SUN ; Yang SHEN ; Hongkui LIU ; Jianping LIU ; Zhaolan LIU
Journal of Traditional Chinese Medicine 2025;66(11):1094-1098
Green prescription is a written prescription aimed at improving health by promoting physical activity and improving diet, with advantages such as high cost-effectiveness, strong feasibility, and minimal harm to patients. The theory of traditional Chinese medicine (TCM) green prescription integrates the health philosophy of "following rule of yin and yang, and adjusting ways to cultivating health", the exercise philosophy of balancing yin-yang and the five elements, and the dietary philosophy of moderation and balance, which embody core TCM concepts such as treating disease before its onset and harmony between humans and nature. It has also developed traditional exercise practices like Tai Chi, Baduanjin, Wuqinxi, Yi-Gin-Ching, and Qigong, as well as dietary adjustments like medicated diet and herbal wines. However, it is believed that the TCM green prescription currently suffers from insufficient evidence-based research, low patient awareness and acceptance, and weak basic research. Based on this, it is proposed that large-sample clinical trials should be conducted in the future to improve the quality of evidence-based medicine, basic research can be carried out with the help of artificial intelligence and other methods in research design, the hospital information system (HIS) can be used for control at the implementation level, and publicity and patient education can be strengthened through the new media, so as to promote the development and application of the TCM green prescriptions in the field of global health treatment.
2.Randomized Controlled Trial Design Based on Patient Cohorts: Methods and Applications of Trials Within Cohorts
Yuyi WANG ; Zeyang SHI ; Kecheng LI ; Zhijun BU ; Xuehui WANG ; Bin WANG ; Jianping LIU ; Zhaolan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):96-102
Trials within cohorts (TwiCs) are design methods derived from randomized controlled trials (RCTS). They have been widely used in chronic disease areas such as tumors and cardiovascular diseases. The basis of the TwiCs design is a prospective cohort of specific diseases. When RCTS need to be implemented, some patients meeting the inclusion and exclusion criteria are randomly sampled from the cohort to receive "trial interventions", while the remaining patients in the cohort who meet the inclusion and exclusion criteria continue to receive conventional treatment as control groups. By comparing the efficacy differences between the intervention measures of the trial group and the control group, the efficacy of intervention measures was evaluated. Within the cohort, the same process could be repeated to carry out multiple RCTS, so as to evaluate different intervention measures or compare the efficacy of different doses or timing of interventions. Compared with classical RCTS, TwiCs make it easier to recruit patients from the cohort and have higher external validity, providing a new research paradigm for improving the efficiency and applicability of RCTS in clinical practice. However, TwiCs may also face the challenge of poor compliance of patients in the cohort. Researchers need to take effective measures to control these patients in the design and operation of TwiCs. This article focused on the methodological key points during the implementation of TwiCs, including multi-stage informed consent (patients are informed of consent at three stages: entering the cohort, entering the trial group, and after the trial), randomization procedures (only random sampling of patients from the cohort to receive "trial interventions"), sample size calculation, and statistical analysis methods. The article also compared the differences between TwiCs and traditional RCTS and illustrated TwiCs research design and analysis with examples, so as to provide new research ideas and methods for clinical researchers.
3.Association between prolactin/testosterone ratio and breast cancer in Chinese women.
Qian CAI ; Xiaohan TIAN ; Yuyi TANG ; Han CONG ; Jie LIU ; Song ZHAO ; Rong MA ; Jianli WANG ; Jiang ZHU
Chinese Medical Journal 2024;137(3):368-370
4.Application of Quality Evaluation of Blind Method in Clinical Trials of Traditional Chinese Medicine
Zeyang SHI ; Yuan SUN ; Wenxin MA ; Yuyi WANG ; Zhijun BU ; Xuehui WANG ; Youyou ZHENG ; Jianping LIU ; Zhaolan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(3):75-80
The quality evaluation of the blind method is to evaluate the clinical blind data obtained from clinical trials adopting the blind method and judge the effectiveness of the blind method by investigating the blind effect of different blind objects. A successful blind method can avoid the influence of subjective factors on the test results of subjects and researchers to a certain extent. The quality evaluation of the blind method can reflect not only the effectiveness of the blind method but also the accuracy and credibility of clinical trial results. In recent years, randomized controlled trials have been widely used in the evaluation of the clinical efficacy of traditional Chinese medicine (TCM), but the quality of the implementation of blind methods is uneven, and the evaluation criteria have not yet been formed. In this paper, the data collection methods, calculation principles, advantages, and disadvantages of two quantitative quality evaluation methods of blind methods, namely James Blinding Index (JBI) and Bang Blinding Index (BBI), were introduced. The two indexes were analyzed in a randomized controlled trial of acupuncture and moxibustion to relieve postoperative oral pain. The calculation process of the results was demonstrated by R software and visualized by forest map. At the same time, a tool table was designed to facilitate the collection of evaluation data of blind methods in TCM clinical trials at different stages. Finally, the necessity and feasibility of quality evaluation of blind method in TCM research were discussed to provide a basis for evaluating and improving the quality of blind method implementation in TCM clinical trials.
5.Meta analysis and GRADE evidence level evaluation of therapeutic efficacy and safety of plum-blossom needle in treating vitiligo
Shumei CHEN ; Kaizhong ZHANG ; Tingting LI ; Tinglu WEN ; Ju YU ; Jin WANG ; Yuyi WANG
Chongqing Medicine 2024;53(1):121-126
Objective To systematically evaluate the efficacy and safety of plum-blossom needle therapy for vitiligo by using the systematic review and meta analysis.Methods The randomized controlled trials(RCT)on plum-blossom needle for treating vitiligo were systematically retrieved from the databases of the PubMed,China Biological Medicine Database,CNKI,Wanfang Data and VIP database from the database estab-lishment to June 2,2022.The literatures were screened according to the inclusion and exclusion criteria.The finally included literatures conducted the data extraction.The RevMan 5.4 software was used for conducting the data analysis.The methodological quality evaluation on the included trials was performed by the ROB tool.The GRADE method was used to assess the evidence level.Results A total of 7 trials involving 469 pa-tients were finally included.The meta analysis results showed that the plum-blossom needle combined with other therapies(including laser or ultraviolet irradiation,tacrolimus ointment,compound Kaliziran tincture)was superior to the other therapies alone in the aspects of improving vitiligo skin lesion including reducing the of white spot skin lesion area(MD=-1.11,95%CI:-1.92 to-0.30,P=0.007),increasing the repigment-ation rate of vitiliginous lesions(MD=18.09,95%CI:1.55 to 34.63,P=0.030)and enhancing the pigment deposition in vitiligo lesions(MD=0.92,95%CI:0.32 to 1.52,P=0.003),and improving the patients'quali-ty of life(MD=-7.48,95%CI:-8.04 to-6.92,P<0.001),and the differences were statistically signifi-cant.In terms of safety,there was no statistically significant difference in adverse events between plum blos-som acupuncture combined with other therapies and other therapies alone(RR=1.20,95%CI:0.77 to 1.84,P=0.420).Conclusion Low or very low evidence shows that plum-blossom needle combined with other therapies for treating vitiligo may enhance the effect in the aspects of improving the white spot skin lesions and quality of life in the patients with vitiligo,moreover which is relatively safe.
6.Application of non-coding RNAs in radiotherapy resistance in head and neck tumors
Yuyi LI ; Chao TAN ; Feng LIU ; Kailin CHEN ; Hui WANG
Chinese Journal of Radiation Oncology 2024;33(10):958-963
Radiotherapy plays a key role in the treatment of head and neck tumors, which can not only serve as a curative treatment, but also as an adjuvant treatment after surgery to improve the local control rate. In addition, radiotherapy also helps preserve important organ functions, such as laryngeal function or facial appearance, which is of great significance for the treatment and rehabilitation of patients. Despite advances in radiotherapy technology, some patients still experience resistance to radiation therapy, resulting in treatment failure. Non-coding RNA (ncRNA) is considered to be the main type of RNA transcription, which is usually not translated into proteins, and mainly functions through the interaction with proteins, chromatins and mRNAs, and is a molecular marker for a variety of tumors, involving tumor proliferation, apoptosis, invasion and migration, etc. Many studies have shown that dysregulated ncRNA play an important role in radiotherapy resistance in head and neck tumors. Therefore, this article reviews the research progress of ncRNA in radiotherapy resistance in head and neck tumors, aiming to better understand the role of ncRNA in the occurrence and development of radiotherapy resistance, and provide reference for formulating more effective strategies for preventing radiotherapy resistance.
7.Phenolic-enabled nanotechnology:a new strategy for central nervous system disease therapy
ZHENG YUYI ; CHEN XIAOJIE ; WANG YI ; CHEN ZHONG ; WU DI
Journal of Zhejiang University. Science. B 2024;25(10):890-913
Polyphenolic compounds have received tremendous attention in biomedicine because of their good biocompatibility and unique physicochemical properties.In recent years,phenolic-enabled nanotechnology(PEN)has become a hotspot of research in the medical field,and many promising studies have been reported,especially in the application of central nervous system(CNS)diseases.Polyphenolic compounds have superior anti-inflammatory and antioxidant properties,and can easily cross the blood?brain barrier,as well as protect the nervous system from metabolic damage and promote learning and cognitive functions.However,although great advances have been made in this field,a comprehensive review regarding PEN-based nanomaterials for CNS therapy is lacking.A systematic summary of the basic mechanisms and synthetic strategies of PEN-based nanomaterials is beneficial for meeting the demand for the further development of novel treatments for CNS diseases.This review systematically introduces the fundamental physicochemical properties of PEN-based nanomaterials and their applications in the treatment of CNS diseases.We first describe the different ways in which polyphenols interact with other substances to form high-quality products with controlled sizes,shapes,compositions,and surface chemistry and functions.The application of PEN-based nanomaterials in the treatment of CNS diseases is then described,which provides a reference for subsequent research on the treatment of CNS diseases.
8.Discussion on the validity period determination method of commercial ready-to-use TSA medium
Wenyue KOU ; Yuru JIANG ; Luyao HAO ; Yuyi TANG ; Xueyun ZHOU ; Xiujuan ZHU ; Zhen QIAN ; Ge JIN ; Jiaojiao WANG
Drug Standards of China 2024;25(3):289-295
Objective:To study the quality and stability of commercial ready-to-use tryptone soya agar(TSA)after storing at 2-25 ℃ for different storage duration under dark condition in order to discuss a determination method of validity period for medium.Methods:Three consecutive batches of ready-to-use TSA medium from two manufac-turers were selected and stored at 2-25 ℃ under dark conditions for 30,90 and 180 days,respectively.The appearance,pH,medium suitability and sterility of the medium were tested.Results:The results of appearance,pH,suitability and sterility of TSA medium from two manufacturers for each batch under different storage duration all met the requirements of the Chinese Pharmacopoeia 2020 Volume IV on the quality control of medium.Conclusion:The TSA medium from two manufacturers all met the requirements when stored for 180 days at 2-25 ℃ under dark condition,indicating that the validity period of TSA medium from two manufacturers can reach 180 days.
9.Applications and recent advances in transdermal drug delivery systems for the treatment of rheumatoid arthritis.
Yuyi XU ; Ming ZHAO ; Jinxue CAO ; Ting FANG ; Jian ZHANG ; Yanli ZHEN ; Fangling WU ; Xiaohui YU ; Yaming LIU ; Ji LI ; Dongkai WANG
Acta Pharmaceutica Sinica B 2023;13(11):4417-4441
Rheumatoid arthritis is a chronic, systemic autoimmune disease predominantly based on joint lesions with an extremely high disability and deformity rate. Several drugs have been used for the treatment of rheumatoid arthritis, but their use is limited by suboptimal bioavailability, serious adverse effects, and nonnegligible first-pass effects. In contrast, transdermal drug delivery systems (TDDSs) can avoid these drawbacks and improve patient compliance, making them a promising option for the treatment of rheumatoid arthritis (RA). Of course, TDDSs also face unique challenges, as the physiological barrier of the skin makes drug delivery somewhat limited. To overcome this barrier and maximize drug delivery efficiency, TDDSs have evolved in terms of the principle of transdermal facilitation and transdermal facilitation technology, and different generations of TDDSs have been derived, which have significantly improved transdermal efficiency and even achieved individualized controlled drug delivery. In this review, we summarize the different generations of transdermal drug delivery systems, the corresponding transdermal strategies, and their applications in the treatment of RA.
10.Inhibition of subicular seizure-labeled c-fos+ neurons alleviates cognitive deficit in epilepsy
Lin YANG ; Qi ZHANG ; Xueqing WU ; Xiaoyun QIU ; Fan FEI ; Nanxi LAI ; Yuyi ZHENG ; Mengdi ZHANG ; Qingyang ZHANG ; Yu WANG ; Fei WANG ; Cenglin XU ; Yeping RUAN ; Yi WANG ; Zhong CHEN
Chinese Journal of Pharmacology and Toxicology 2023;37(7):482-483
OBJECTIVE Cognitive deficit is a com-mon comorbidity in temporal lobe epilepsy(TLE)and that is not well controlled by current therapeutics.Currently,how epileptic seizure affects cognitive performance remains largely unclear.The subiculum is the major out-put of the hippocampus,which projects to entorhinal cor-tex and other more distinct brain regions.Physiologically,the subiculum codes spatial working memory and naviga-tion information including place,speed,and trajectory.Importantly,prior studies have noted the importance of the subiculum in the beginning,spreading,and generaliz-ing process of hippocampal seizure.How seizure-activated neurons in subiculum participate in cognitive impairment remains largely elusive.METHODS In this study,we sought to label the subicular seizure-activated c-fos+ neu-rons with a special promoter with enhanced synaptic activity-responsive element E-SARE in the subiculum,combined with chemogenetics and designer receptors exclusively activated by designer drugs(DREADDs),Ca2+ fiber photometry approaches,and behavioral tasks,to reveal the role of these neurons in cognitive impairment in epilepsy.RESULTS We found that chemogenetic inhibi-tion of subicular seizure-tagged c-fos+ neurons(mainly CaMK Ⅱ α+ glutamatergic neurons)alleviates seizure generalization and improves cognitive performance in the hippocampal CA3 kindling TLE model.While inhibition of seizure-labeled c-fos+ GABAergic interneuron shows no effect on seizure and cognition.As a comparison,che-mogenetic inhibition of the whole subicular CaMK Ⅱ α+ neuron impairs cognitive function in na?ve mice in basal condition.Notably,inhibition of subicular seizure-tagged c-fos+ neurons enhances the recruitment of cognition-responsive c-fos+ neurons via increasing neural excitability during cognition tasks.CONCLUSION Our results dem-onstrate that subicular seizure-activated c-fos+ neurons contribute to cognitive impairment in TLE,suggesting sei-zure-tagged c-fos+ neurons as the potential therapeutic target to alleviate cognitive impairment in TLE.

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