1.Early combination of Ranibizumab and Dexamethasone intravitreal implant in the treatment of macular edema secondary to retinal vein occlusion
Chaofan WANG ; Shuliang DING ; Junxing YANG ; Zijing FENG ; Dengfeng XU ; Jianliang LIU
International Eye Science 2025;25(4):644-649
AIM:To compare the efficacy and safety of early combination therapy with ranibizumab and dexamethasone intravitreal implants versus ranibizumab monotherapy for the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).METHODS: A retrospective cohort study was conducted on a total of 62 cases(64 eyes)of patients who were first diagnosed with RVO-ME at the Eye Centre of the Affiliated Hospital of Shandong Second Medical University between February 2022 and February 2023. The subjects were divided into two groups according to the different treatment regimens: 32 cases(34 eyes)in the monotherapy group received only ranibizumab [3+pro re nata(PRN)regimen], and 30 cases(30 eyes)in the combination therapy group were injected with ranibizumab once first, followed by dexamethasone intravitreal implant 3 wk later(1+DEX regimen). The best corrected visual acuity(BCVA), central retina thickness(CRT), foveal avascular zone(FAZ)area, macular vascular density(MVD)at the level of the deep vascular complex(DVC)of the retina, the incidence of ocular adverse effects, the number of drug injections, and the total cost between the two groups were compared before and after treatment.RESULTS: At 3 wk, 3 and 6 mo, and at the final follow-up of the two groups of patients, the improvement in BCVA, CRT, and MVD in the DVC layer was significantly better than that before treatment(all P<0.05); there were differences in the comparisons of BCVA and CRT between the two groups at 6 mo and the final follow-up(all P<0.05), and the increase in the number of letters of BCVA was the most pronounced in the combination therapy group at 6 mo of treatment. Statistical significant difference was observed in the comparison of MVD in the DVC layer between the two groups at 3 and 6 mo after treatment and at the final follow-up(all P<0.05). However, no significant change in FAZ area was evident before and after treatment in both groups(P>0.05). The combination therapy group exhibited a reduced number of injections and total cost in comparison to the monotherapy group. The combination therapy group exhibited a slightly higher incidence of high intraocular pressure and cataract progression compared to the monotherapy group, with no statistical significant difference(all P>0.05). Furthermore, no serious adverse events were observed in either group following treatment.CONCLUSION:Compared with ranibizumab alone, ranibizumab combined with dexamethasone intravitreal implant significantly improved vision, reduced macular edema, and lowered the frequency of injections and total treatment cost in patients with RVO-ME. CRT and MVD in the DVC layer are reliable prognostic indicators for patients with RVO-ME.
2.Mechanism of Anmeidan in Improving Learning and Memory in Insomnia Model Rats by Mediating Immunoinflammation via cGAS/STING Signaling Pathway
Bo XU ; Zijing YE ; Ping WANG ; Jing CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):27-35
ObjectiveTo investigate the mechanism by which Anmeidan improves learning and memory in insomnia rats by regulating the cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway to influence immunoinflammation. MethodsSixty SD rats were randomly divided into a blank group, a model group, a suvorexant group (30 mg·kg-1), and Anmeidan low-, medium-, and high-dose groups (4.55, 9.09, and 18.18 g·kg-1), with 10 rats in each group. The insomnia rat model was induced by intraperitoneal injection of p-chlorophenylalanine (PCPA). Anmeidan decoction and normal saline were administered by gavage for 28 days at the corresponding doses. Morris water maze and new object recognition tests were used to assess learning and memory functions. Hematoxylin-eosin (HE) staining and Nissl staining were performed to observe hippocampal cell morphology. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of interleukin-1 (IL-1), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-12 (IL-12), interleukin-18 (IL-18), and tumor necrosis factor-α (TNF-α). Western blot and Real-time quantitative polymerase chain reaction(Real-time PCR) were used to detect the relative protein and mRNA expression levels of hippocampal cGAS and STING. ResultsCompared with the blank group, the 5-HT content in the model group was significantly reduced (P<0.01). The latency to the upper platform and total distance were significantly increased (P<0.05, P<0.01), while the residence time in the target quadrant and the number of platform crossings were significantly reduced (P<0.01), and the relative recognition index for new objects was significantly lower (P<0.01). The morphology and arrangement of hippocampal neurons were loose and disordered, with a decreased number of intracellular Nissl bodies. The relative expression levels of IL-1, IL-1β, IL-6, IL-8, IL-12, IL-18, TNF-α, cGAS, and STING pathway proteins and mRNA were significantly upregulated (P<0.01). Compared with the model group, the latency to the upper platform in the high-dose Anmeidan group was significantly shortened (P<0.05). In the medium- and high-dose Anmeidan groups and the suvorexant group, the residence time in the target quadrant and the number of platform crossings were significantly increased (P<0.01). The total distance traveled was significantly reduced (P<0.01), and the relative recognition index for new objects was significantly increased (P<0.01). The hippocampal neurons were more neatly arranged, and the number of intracellular Nissl bodies increased. The expression of IL-1, IL-1β, IL-6, IL-8, IL-12, IL-18, TNF-α, and cGAS proteins and mRNA in the medium- and high-dose Anmeidan groups was significantly downregulated (P<0.05, P<0.01). ConclusionAnmeidan improves learning and memory in insomnia rats, possibly by suppressing immunoinflammation through inhibition of the cGAS/STING signaling pathway.
3.Differences and Mechanisms of Combined Use of "Raw and Fried Ziziphi Spinosae Semen" in Anmeidan and Its Disassembled Prescriptions in Improving Anxiety and Cognitive Impairment in Insomnia Rat Model Based on Serum Metabolomics
Kang SUN ; Bo XU ; Zijing YE ; Miao ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):36-43
ObjectiveTo investigate the differences in efficacy and endogenous metabolic mechanisms of Anmeidan with combined use of raw and fried Ziziphi Spinosae Semen and its disassembled prescriptions in treating anxiety and cognitive impairment in insomnia rats. MethodsSixty rats were randomly divided into six groups (n=10 per group): blank group, model group, suvorexant group (30 mg·kg-1), Anmeidan group (9.09 g·kg-1), Anmeidan with absence of raw Ziziphi Spinosae Semen group (7.38 g·kg-1), and Anmeidan with absence of fried Ziziphi Spinosae Semen group (7.38 g·kg-1). An insomnia model was constructed by intraperitoneal injection of para-chlorophenylalanine (PCPA), followed by gavage administration of Anmeidan or its disassembled prescriptions. Anxiety levels were assessed using the open field test, while cognitive ability was evaluated via the novel object recognition test. The pathological morphology of hippocampal neurons was examined using electron microscopy. Serum samples were analyzed by ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) for principal component analysis, metabolic profiling, identification of differential metabolites, and metabolic pathway analysis. ResultsCompared with the blank group, the model group exhibited significantly increased exercise mileage, exercise time, and the ratio of the number of entries into the peripheral zone to the total number of entries into both the peripheral and central zones exhibited a marked increase (P<0.05, P<0.01), while the novel object recognition index significantly decreased (P<0.05). Compared with the model group, the Anmeidan and suvorexant groups showed significantly reduced exercise mileage and exercise time (P<0.01). The ratio of the number of entries into the peripheral zone to the total number of entries into both the peripheral and central zones decreased (P<0.05), and a significant increase in the novel object recognition index (P<0.01). However, the disassembled prescription groups showed no significant improvement in open field test and novel object recognition test indices. Electron microscopy revealed that the Anmeidan group improved the pathological morphology of hippocampal neurons in insomnia rats. Metabolomics analysis identified 10 potential differential metabolites associated with Anmeidan's therapeutic effects, involving metabolic pathways related to phenylalanine and tryptophan biosynthesis and metabolism, as well as the serotonergic pathway. ConclusionThe combined use of raw and fried Ziziphi Spinosae Semen in Anmeidan is more effective than its disassembled prescriptions in alleviating anxiety and cognitive impairment in PCPA-induced insomnia rats. The underlying mechanism may be associated with metabolic pathways related to phenylalanine, tryptophan, and serotonin.
4.Effect of Anmeidan on Cognitive Function and Metabolic Profiling in Insomnia Model Rats Based on Untargeted Metabolomics
Feizhou LI ; Bo XU ; Zijing YE ; Lianyu LI ; Andong ZHANG ; Ping WANG ; Linlin CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):54-64
ObjectiveTo elucidate the potential mechanisms by which the classic prescription Anmeidan alleviates cognitive impairment in insomnia model rats through metabolic profiling. MethodsA total of 60 SD rats were randomly divided into six groups: blank group, model group, low-, medium-, and high-dose Anmeidan groups, and the Suvorexant group, with 10 rats in each group. Except for the blank group, the insomnia model was established in all other groups via intraperitoneal injection of para-chlorophenylalanine. The Suvorexant group was administered Suvorexant solution (30 mg·kg-1·d-1) by gavage, while the low-, medium-, and high-dose Anmeidan groups received Anmeidan decoction (4.55, 9.09, 18.18 g·kg-1·d-1) by gavage. The blank group received an equivalent volume of normal saline. The open field test was used to assess spatial exploration and anxiety/depressive-like behaviors in rats. Serum levels of epidermal growth factor (EGF), brain-derived neurotrophic factor (BDNF), and vasoactive intestinal peptide (VIP) were measured using enzyme-linked immunosorbent assay (ELISA). Untargeted metabolomics was employed to identify differential metabolites in rat serum, and systematic biological methods were applied to analyze the potential targets and pathways of Anmeidan. ResultsCompared to the blank group, the model group exhibited significant reductions in total distance traveled, average speed, number of entries into the central area, time spent in the central area, and frequency of upright events (P<0.01), along with significant decreases in VIP, EGF, and BDNF levels (P<0.05,P<0.01). A total of 100 differential metabolites were identified between the model and blank groups. Compared to the model group, the low-, medium-, and high-dose Anmeidan groups showed significant increases in total distance traveled, average speed, number of entries into the central area, time spent in the central area, and frequency of upright events (P<0.05,P<0.01), as well as a significant increase in VIP levels (P<0.05,P<0.01). Anmeidan significantly reversed abnormal changes in 67 metabolites compared to the model group. A combined analysis identified 134 potential targets of Anmeidan, with network topology analysis suggesting that Caspase-3, B-cell lymphoma 2 (Bcl-2), nuclear transcription factor-κB (NF-κB), interleukin-1β (IL-1β), interleukin-2 (IL-2), matrix metalloproteinase-9 (MMP-9), and Toll-like receptor 4 (TLR4), among others, may serve as key targets of Anmeidan. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed major enriched pathways, including the cyclic adenosine monophosphate (cAMP) signaling pathway, hypoxia inducible factor-1 (HIF-1) signaling pathway, and IL-17 signaling pathway. ConclusionThis study demonstrates that Anmeidan can recalibrate abnormal metabolic profiles in insomnia model rats to mitigate cognitive impairment, with its mechanisms of action potentially involving the regulation of immune-inflammatory responses, energy metabolism, and apoptosis-related pathways.
5.Anmeidan Regulates Hepatic Neurotransmitters and Circadian Rhythm in Rat Model of Insomnia via OX1R/PLCβ-1/PKCα/ERK1/2 Signaling Pathway
Bo XU ; Ping WANG ; Jing XIA ; Guangjing XIE ; Zijing YE ; Qinghua QIN ; Jing CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(15):11-20
ObjectiveTo explore the effect and mechanism of the classic famous prescription Anmeidan (AMD) developed in the Qing Dynasty in regulating the hepatic neurotransmitters and circadian rhythm in the rat model of insomnia via the orexin-1 receptor (OX1R)/phosphatidylinositol-specific phospholipase Cβ-1 (PLCβ-1)/protein kinase Cα (PKCα)/extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway. MethodSixty SPF-grade SD rats were randomized into blank, model, suvorexant (30 mg·kg-1·d-1), and low-, medium-, and high-dose (4.55, 9.09, 18.09 g·kg-1·d-1, respectively) AMD groups, with 10 rats in each group. The rats in other groups except the blank group were modeled by intraperitoneal injection of p-chlorophenylalanine (PCPA) and administrated with corresponding drugs by gavage, and the blank group received an equal volume of normal saline. The general condition, body mass, and 24 h autonomic activity of each group were observed. The pathological changes of the liver tissue were observed by hematoxylin-eosin(HE)staining and Masson staining. The expression of gamma-aminobutyric acid (GABA), 5-hydroxytryptamine (5-HT), epinephrine (EPI), norepinephrine (NE), and acetylcholine (ACh) in the liver tissue was detected by enzyme-linked immunosorbent assay. The glutamate (Glu) expression in the liver tissue was detected by the biochemical method. The mRNA levels of biological clock genes Per1, Per2, Cry1, Cry2, Bmal1, and Bmal2 in the liver were determined by Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). The protein and mRNA levels of factors in the OX1R/PLCβ-1/PKCα/ERK1/2 signaling pathway in the liver were determined by Western blot and Real-time PCR, respectively. ResultCompared with the blank group, the modeling decreased the body mass (P<0.05, P<0.01) and caused mania and disturbed resting rhythms (P<0.01), hepatic muscle fiber fracture, and edema with inflammatory cell infiltration. In addition, the modeling decreased the GABA, 5-HT, EPI, NE, and ACh content, increased Glu content (P<0.01), down-regulated the mRNA levels of Per1, Per2, Cry1, and Cry2 (P<0.01), up-regulated the mRNA levels of Bmal1 and Bmal2 (P<0.01), and promoted the expression of OX1R, PLCβ-1, PKCα, and ERK1/2 at both protein and mRNA levels (P<0.01). Compared with the model group, suvorexant and AMD increased the body mass (P<0.05, P<0.01), alleviated the mania, and increased the resting time and frequency (P<0.05, P<0.01). Moreover, the medications elevated the levels of GABA, 5-HT, EPI, NE, and ACh, lowered the Glu level, up-regulated the mRNA levels of Per1, Per2, Cry1, and Cry2 (P<0.05, P<0.01), down-regulated the mRNA levels of Bmal1 and Bmal2, and inhibited the expression of OX1R, PLCβ-1, PKCα, and ERK1/2 at both mRNA and protein levels (P<0.05, P<0.01). ConclusionAMD can regulate hepatic neurotransmitters and improve circadian rhythm in insomniac rats by inhibiting the OX1R/PLCβ-1/PKCα/ERK1/2 signaling pathway, and high-dose AMD demonstrated the strongest effect.
6.Study on the Mechanism of AMD Regulating Orexin Signaling Pathway to Improve Learning and Memory of SD zebrafish Model
Zijing YE ; Bo XU ; Jing XIA ; Haifei LU ; Yumeng CHEN ; Mengying HUANG ; Ping WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(3):731-741
Objective To observe the effects of AnMeiDan(AMD),a representative formula of Peiyuan Guben Tranquilisation method,on the learning memory of zebrafish model of sleep deprivation(SD),and to explore the possible mechanism and the optimal apparent dose based on the Orexin signalling pathway.Methods 120 4-month-old wild-type AB line zebrafish were randomly divided into blank group,model group,AMD low-dose group(0.009 mg·mL-1·d-1),AMD medium-dose group(0.027 mg·mL-1·d-1),AMD high-dose group(0.081 mg·mL-1·d-1),and melatonin group(0.4 mg·mL-1·d-1).Zebrafish SD model was established by LED light induction method,24 h behavioural changes of zebrafish in each group were monitored by zebrafish behavioural tracking system,differences in learning and memory ability of zebrafish in each group were detected by T-maze,the state and number of neurons in the brain of zebrafish in each group were observed by Hematoxylin-Eosin(HE)staining method,the structural changes of neurons in the brain of zebrafish in each group were observed by transmission electron microscopy,and changes in neuron structure in the brain of zebrafish in each group were detected by ELISA method.The levels of Orexin A(OXA)and Orexin B(OXB)in zebrafish were detected by enzyme-linked immunosorbent assay(ELISA),and the protein and mRNA expression levels of OXA/p38 mitogen-activated protein kinase(P38 MAPK)/extracellular regulated protein kinase(ERK1/2)were detected by protein immunoblotting and real-time fluorescence quantitative assay(RT-PCR)in zebrafish.Results Compared with the blank group,the total number of rests,duration and distance were reduced in the model group(P<0.05),and the latency to enter the target region(OR)was prolonged(P<0.01);the number of neuronal cells was reduced,the nuclei were degenerated(P<0.01),cytoplasmic hyalinosis was increased(P<0.01),and light colouring was observed,the nuclei were collapsed,the nuclear membranes were ruptured and lysed,the chromatin was solidified,and the mitochondria were swollen and deformed with internal cavities,and lamellipod-like myelin-like structure was formed;the brain tissue OXA,OXA,and ERK1/2 expression levels of the mRNAs and the mRNAs of these signaling pathways were increased(P<0.01).brain tissue OXA and OXB proteins were significantly elevated,OXA mRNA and protein were significantly up-regulated,and P38 MAPK and ERK1/2 mRNA and protein were significantly down-regulated(P<0.01).Compared with the model group,the drug intervention could prolong the total resting exercise time of SD zebrafish(P<0.05);shorten the latency of zebrafish to reach OR(P<0.05);protect the structure and morphology of neuronal cells,and alleviate the damage of brain tissues;reduce the content of OXA and OXB in the brain tissues(P<0.01);and down-regulate the expression of OXA mRNA and protein(P<0.01),and up-regulate the P38 MAPK and ERK1/2 mRNA and protein expression of P38 MAPK and ERK1/2(P<0.01);and the quantity-effect relationship was obvious,and the effect of high dose of AMD was optimal.Conclusion AMD can improve the learning and memory ability in zebrafish SD model,and its mechanism may be related to the regulation of OXA/P38 MAPK/ERK1/2 signalling pathway and alleviation of neuronal damage in the brain,and the high dose group of AMD showed the best effect.
7.Reducing language barriers, promoting information absorption, and communication using fanyi
Difei WANG ; Guannan CHEN ; Lin LI ; Shaodi WEN ; Zijing XIE ; Xiao LUO ; Li ZHAN ; Shuangbin XU ; Junrui LI ; Rui WANG ; Qianwen WANG ; Guangchuang YU
Chinese Medical Journal 2024;137(16):1950-1956
Interpreting genes of interest is essential for identifying molecular mechanisms, but acquiring such information typically involves tedious manual retrieval. To streamline this process, the fanyi package offers tools to retrieve gene information from sources like National Center for Biotechnology Information (NCBI), significantly enhancing accessibility. Additionally, understanding the latest research advancements and sharing achievements are crucial for junior researchers. However, language barriers often restrict knowledge absorption and career development. To address these challenges, we developed the fanyi package, which leverages artificial intelligence (AI)-driven online translation services to accurately translate among multiple languages. This dual functionality allows researchers to quickly capture and comprehend information, promotes a multilingual environment, and fosters innovation in academic community. Meanwhile, the translation functions are versatile and applicable beyond biomedicine research to other domains as well. The fanyi package is freely available at https://github.com/YuLab-SMU/fanyi.
8.Preparation and preliminary evaluation of sodium alginate/agarose/carboxymethyl chitosan spray film dressing carrying platelet rich plasma for wound repair
Yubing XU ; Zhanhong ZHU ; Guangya LIU ; Li CHEN ; Zijing ZHU ; Mou ZHOU ; Guiqiu SHAN
Chinese Journal of Blood Transfusion 2023;36(2):136-140
【Objective】 To develop a spray-on membrane dressing for wound repair containing platelet rich plasma (PRP) sodium alginate (SA)/agarose(AG)/carboxymethyl chitosan (CMCS). 【Methods】 SA/AG/ CMCS were mixed in different proportions to prepare biodegradable quick setting spray (BQSS) by blending film method, and the film-forming time, moisture retention and compression resistance of the prepared BQSS were tested. Then PRP and BQSS were mixed in the proportion of 3∶7, 4∶6, 5∶5, 6∶4 and 7∶3 to prepare PRP-BQSS spray film dressings. The film-forming time, moisture retention, compressive strength, porosity and slow-release effect of growth factors of PRP-BQSS spray film dressings were studied. 【Results】 In the preparation of BQSS compound spray film solution, when SA, AG, CMCS and sterile distilled water were 0.6∶0.6∶0.6∶98.2g, the film-forming time (7.73±0.31) s, moisture retention (75. 54±3.03) % and compression resistance (791.00±68.02) g of the spray-film dressing were the best. The basic properties of PRP-BQSS spray-on film dressings and the release of growth factors show that PRP-BQSS spray-on film dressings can exist in different forms, and with the decrease of PRP concentration percentage, its film-forming time, moisturizing performance and compressive strength showed an upward trend. When the PRP content is 30%, the porosity of the dressing is the highest, about(84.34±0.90)%. The release of platelet-derived growth factor-AA(PDGF-AA), platelet factor-4(PF-4) and transforming growth factor beta (TGF-β) was in a slow upward trend, and the release of the three growth factors was higher than that of PRP group in 48 hours. 【Conclusion】 The preparation method of PRP-BQSS spray film dressing designed in this study is simple and mild, and can form a film quickly, with good biological properties and better growth factor inhibition and sustained-release effect.
9.Glutaredoxin-1 alleviates acetaminophen-induced liver injury by decreasing its toxic metabolites
Ying XU ; Yan XIA ; Qinhui LIU ; Xiandan JING ; Qin TANG ; Jinhang ZHANG ; Qingyi JIA ; Zijing ZHANG ; Jiahui LI ; Jiahao CHEN ; Yimin XIONG ; Yanping LI ; Jinhan HE
Journal of Pharmaceutical Analysis 2023;13(12):1548-1561
Excessive N-acetyl-p-benzoquinone imine(NAPQI)formation is a starting event that triggers oxidative stress and subsequent hepatocyte necrosis in acetaminophen(APAP)overdose caused acute liver failure(ALF).S-glutathionylation is a reversible redox post-translational modification and a prospective mechanism of APAP hepatotoxicity.Glutaredoxin-1(Glrx1),a glutathione-specific thioltransferase,is a primary enzyme to catalyze deglutathionylation.The objective of this study was to explored whether and how Glrx1 is associated with the development of ALF induced by APAP.The Glrx1 knockout mice(Glrx1-/-)and liver-specific overexpression of Glrx1(AAV8-Glrx1)mice were produced and underwent APAP-induced ALF.Pirfenidone(PFD),a potential inducer of Glrx1,was administrated preceding APAP to assess its protective effects.Our results revealed that the hepatic total protein S-glutathionylation(PSSG)increased and the Glrx1 level reduced in mice after APAP toxicity.Glrx1-/- mice were more sensitive to APAP overdose,with higher oxidative stress and more toxic metabolites of APAP.This was attributed to Glrx1 deficiency increasing the total hepatic PSSG and the S-glutathionylation of cytochrome p450 3a 11(Cyp3a11),which likely increased the activity of Cyp3a11.Conversely,AAV8-Glrx1 mice were defended against liver damage caused by APAP overdose by inhibiting the S-glutathionylation and activity of Cyp3a11,which reduced the toxic metabolites of APAP and oxidative stress.PFD precede administration upregulated Glrx1 expression and alleviated APAP-induced ALF by decreasing oxidative stress.We have identified the function of Glrx1 mediated PSSG in liver injury caused by APAP overdose.Increasing Glrx1 expression may be investigated for the medical treatment of APAP-caused hepatic injury.
10.Research on the Construction of Trigger Index System for Dynamic Adjustment of Medical Service Price in Tangshan
Feng GUO ; Tiemin ZHAI ; Quan WAN ; Zijing XU ; Xiangyu HAO ; Zhihui CAO
Chinese Health Economics 2023;42(12):45-48
Objective:To construct a set of weighted trigger index system for dynamic adjustment of medical service price,so as to provide references and basis for price adjustment of complex medical service projects in Tangshan.Methods:The Delphi expert consultation method was used to demonstrate and determine the index system,and the difference comparison method and product method were used to determine the weight coefficient for each index.Results:The trigger index system of dynamic adjustment of medical service price including 4 first-level indicators,10 second-level indicators and 29 third-level indicators,and the weight coefficient of each indicator was given.Conclusion:The trigger index system of dynamic adjustment of medical service price in Tangshan has high scientificity and reliability,which is helpful for Tangshan to establish a sensitive and moderate price dynamic adjustment mechanism.Considering the affordability of all parties in the price adjustment of medical services in Tangshan,it is conducive to strengthening the total price control and structural adjustment of medical services in Tangshan.

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