1.Expression of Fas, bcl-2, Caspase 3 and Annexin-V in NB4 cell line treated with STI571 in vitro
Dewen ZHOU ; Xiujuan ZHAO ; Liangming MA ; Zhenhua QIAO
Journal of Leukemia & Lymphoma 2008;17(6):412-414
Objective To explore molecular mechanisms of apoptosis induced by STI571 in human acute promyelocytie 1eukemia cell lines NB4.nethods The expression of Annexin-V,Fas,Caspase-3 and bcl-2 in NB4 cells were detected by FCM after the treatment of STI571 at(0.5,1.0,5.0 μmol/L)ranging for 24 h,48 h and 72 h.Results With the increasing dose of STI571,the expression of bcl-2,Caspase-3,Annexin-V,Fas in NB4 changed from(10.22±0.62)declining to (5.82±0.52),from(42.21±1.02)ascending to(52.35±0.83),from(25.A2±1.21)ascending to(37.84±0.63),from(18.21±0.81)to(21.41±1.02)respectively.With the dealing time increasing(24,48,72 h),the expression of bcl-2,Caspase-3,Annexin-V,Fas in NB4,changed from (5.81±0.52)declining to(2.51±0.43),from(52.31±0.83)ascending to(69.51±1.12),from(37.81±0.93)ascending to(78.62±0.83),from(23.41±0.73)to(26.53±1.02)respectively.Conclusion STI571 can enhance the apoptosis program to Ni4 in a time-dependence and dose-dependence manner,but no change to Fas was observed.
2.The research advances of biomechanics of human knee joint ligaments.
Jibin ZHOU ; Zhixiu HAO ; Yiyong YANG ; Rencheng WANG ; Dewen JIN
Journal of Biomedical Engineering 2006;23(4):903-906
Ligaments are the main parts which stabilize the knee joint. How to analog the ligaments in biomechanical model will affect the characteristics of the human knee dynamics and in the computation of the stress in ligaments between two bones. This symposium is aimed at the survey of the simplified method of the ligaments via mechanical parameters, and providing an exact method of constructing model.
Biomechanical Phenomena
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Humans
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Knee Joint
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anatomy & histology
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physiology
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Ligaments, Articular
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anatomy & histology
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physiology
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Models, Anatomic
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Models, Biological
3.Effect of electromagnetic radiation at different bands on the expressions of SOX9 and WT1 in rat Sertoli cells
Hui WU ; Dewen WANG ; Shuiming WANG ; Hongyan ZUO ; Yang LI ; Yabing GAO ; Xinping XU ; Hongmei ZHOU ; Zhentao SU ; Hua YAO ; Ruiyun PENG
Chinese Journal of Radiological Medicine and Protection 2012;32(1):47-51
Objective To explore the changes of SOX9 and WT1 expressions in rat Sertoli cells irradiated by EMP ( electromagnetic pulse),S-HPM ( S-band high power microwave) and X-HPM ( Xband high power microwave).Methods Primary Sertoli cells were isolated from 3-week-old Wistar rats and its purity was immunocytochemistrically indentified with WT1.After exposure to 6 × 104 V/m EMP,100 mW/cm2 S-HPM and X-HPM for 4 min respectively,SOX9 and WT1 expressions in Sertoli cells were determined with real-time PCR and Western blot,respectively.Results SOX9 mRNA expression was decreased at 6 and 12 h post-irradiation of three different bands of electromagnetic microwave ( F =15.20and 4.84,P < 0.05 ).SOX9 protein expression was also decreased at 6 and 24 h after irradiation ( F =8.46 and 7.47,P<0.05).WT1 mRNA expression was decreased at6 and 12 h (F=13.46 and 5.08,P < 0.05 ),but its protein expression was decreased only at 24 h post-irradiation ( F =10.26,P < 0.05 ).Conclusions Three bands of electromagnetic radiation reduce the expressions of SOX9 and WT1 in rat Sertoli cells,which may provide molecular foundation for genital system hazards induced by microwave radiation.
4.Short-term prognostic predictive value of deep-learning assisted quantitative myocardial contrast echocardiography in ST-elevated myocardial infarction after primary percutaneous coronary intervention
Mingqi LI ; Dewen ZENG ; Wenyue YUAN ; Yanxiang ZHOU ; Jinling CHEN ; Sheng CAO ; Hongning SONG ; Bo HU ; Jing CHEN ; Yuanting YANG ; Hao WANG ; Hongwen FEI ; Qing ZHOU
Chinese Journal of Ultrasonography 2023;32(7):572-582
Objective:To explore the prognostic predictive value of deep neural network (DNN) assisted myocardial contrast echocardiography (MCE) quantitative analysis of ST-elevated myocardial infarction (STEMI) patients after successful percutaneous coronary intervention(PCI).Methods:A retrospective analysis was performed in 97 STEMI patients with thrombolysis in myocardial infarction-3 flow in infarct vessel after primary PCI in Renmin Hospital of Wuhan University from June to November 2021. MCE was performed within 48 h after PCI. Patients were followed up to 120 days. The adverse events were defined as cardiac death, hospitalization for congestive heart failure, reinfarction, stroke and recurrent angina. The framework consisted of the U-net and hierarchical convolutional LSTMs. The plateau myocardial contrast intensity (A), micro-bubble rate constant (β), and microvascular blood flow (MBF) for all myocardial segments were obtained by the framework, and then underwent variability analysis. Patients were divided into low MBF group and high MBF group based on MBF values, the baseline characteristics and adverse events were compared between the two groups. Other variables included biomarkers, ventricular wall motion analysis, MCE qualitative analysis, and left ventricular ejection fraction. The relationship between various variables and prognosis was investigated using Cox regression analysis. The ROC curve was plotted to evaluate the diagnostic efficacy of the models, and the diagnostic efficacy of the models was compared using the integrated discrimination improvement index (IDI).Results:The time-cost for processing all 3 810 frames from 97 patients was 377 s. 92.89% and 7.11% of the frames were evaluated by an experienced echocardiographer as "good segmentation" and "correction needed". The correlation coefficients of A, β, and MBF ranged from 0.97 to 0.99 for intra-observer and inter-observer variability. During follow-up, 20 patients met the adverse events. Multivariate Cox regression analysis showed that for each increase of 1 IU/s in MBF of the infarct-related artery territory, the risk of adverse events decreased by 6% ( HR 0.94, 95% CI =0.91-0.98). There was a 4.5-fold increased risk of adverse events in the low MBF group ( HR 5.50, 95% CI=1.55-19.49). After incorporating DNN-assisted MCE quantitative analysis into qualitative analysis, the IDI for prognostic prediction was 15% (AUC 0.86, sensitivity 0.78, specificity 0.73). Conclusions:MBF of the area supplied by infarct-related artery after STEMI-PCI is an independent protective factor for short-term prognosis. The DNN-assisted MCE quantitative analysis is an objective, efficient, and reproducible method to evaluate microvascular perfusion. Assessment of culprit-MBF after PCI in STEMI patients adds independent short-term prognostic information over qualitative analysis.It has the potential to be a valuable tool for risk stratification and clinical follow-up.
5.Construction and application value of CT-based three-dimensional digital model of small bowel for predication of small bowel length before bariatric surgery
Fan ZHANG ; Yi WU ; Xin HU ; Dewen TAN ; Guangyan LI ; Yu GAO ; Zhengyong LIU ; Ji JIANG ; Fang SUN ; Xunmei ZHOU ; Lijuan LIU ; Weidong TONG ; Fan LI
Chinese Journal of Digestive Surgery 2020;19(4):439-443
Objective:To construct a computed tomography (CT)-based three-dimensional digital model of small bowel, and investigate its application value for predication of small bowel length before bariatric surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 patients with obesity who were admitted to the Daping Hospital of Army Medical University from December 2018 to January 2019 were collected. There were 2 males and 1 female, aged from from 24 to 44 years, with a median age of 25 years. Patients underwent abdominal enhanced CT examination before operation, and the three-dimensional digital models of small bowel for each patient were constructed respectively. Of the 3 patients, 2 underwent sleeve gastrectomy and 1 underwent Roux-en-Y gastric bypass. The 3 patients were numbered as No.1, No.2, and No.3 according to the operation time. Observation indicators: (1) construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length; (2) intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length. Count data were represented as absolute numbers or percentages.Results:(1) Construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length: the three-dimensional digital models of small bowel for each patient were constructed respectively before operation. The volume of small bowel, area of each cross-section for the 10 cross-sections of small bowel, average area of cross-section of small bowel, preoperative prediction of small bowel length in the three-dimensional digital model of small bowel of No.1 patient were 1 312 985 mm 3, 174 mm 2, 154 mm 2, 143 mm 2, 172 mm 2, 345 mm 2, 213 mm 2, 357 mm 2, 173 mm 2, 382 mm 2, 154 mm 2, 227 mm 2, 578 cm. The above indicators of No.2 patient were 1 817 224 mm 3, 274 mm 2, 196 mm 2, 487 mm 2, 413 mm 2, 520 mm 2, 254 mm 2, 231 mm 2, 170 mm 2, 212 mm 2, 168 mm 2, 293 mm 2, 620 cm. The above indicators of No.3 patient were 2 183 019 mm 3, 320 mm 2, 408 mm 2, 281 mm 2, 222 mm 2, 194 mm 2, 219 mm 2, 188 mm 2, 419 mm 2, 326 mm 2, 235 mm 2, 281 mm 2, 777 cm. (2) Intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length: the length of small bowel measured intraoperatively for No.1, No.2, and No.3 patients were 570 cm, 600 cm, and 780 cm, respectively. The relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length of No.1, No.2, and No.3 patients were 1.40%、3.33%、0.38%, respectively. Conclusion:Three-dimensional digital model of the small bowel can predict the small bowel length before bariatric surgery.
6.Quality evaluation of registration data of Shenzhen Type 1 Diabetes Alliance: based on the collaborative research platform network of China Type 1 Diabetes Alliance
Xueting LIU ; Haiyan LI ; Lingbo LYU ; Mingzheng LI ; Yan HUANG ; Shu LI ; Hongmei WU ; Qin ZHANG ; Chuanqi CHEN ; Liao SUN ; Zhiguang ZHOU ; Xia LI ; Dewen YAN
Journal of Chinese Physician 2022;24(7):1060-1066
Objective:To evaluate the data quality of Shenzhen Type 1 Diabetes Alliance (SZT1D), and to provide a basis for evaluation and improvement for the continuous improvement of data quality.Methods:From December 2018 to July 2021, 697 first-visit type 1 diabetes (T1DM) patients (including 501 in Shenzhen and 196 out-of-Shenzhen) and 120 re-visited T1DM patients (including 113 in Shenzhen and 7 out-of-Shenzhen) who were registered by SZT1D in collaborative research platform network of China Type 1 Diabetes Alliance (hereinafter referred to as China T1D). The data quality was evaluated from three dimensions: data completion, accuracy and revisit. The data completion degree was evaluated by the overall data completion degree and the key indicator completion degree; the data accuracy was evaluated by the probability of abnormal blood glucose value; the patient′s return visit was evaluated by the return visit rate.Results:The main characteristics of T1DM in SZT1D were young and middle-aged adults [age: (34.4±17.1)years] with thin body [BMI: (19.80±3.52)kg/m 2)], half of male and female patients [proportion of male: 52.4%(365/697)]; the main types of diagnosis were classical T1DM [65.22%(150/230)] and latent autoimmune diabetes in adults(LADA) [26.08%(60/230)], and the fasting blood glucose (FPG) [(10.93±6.98)mmol/L] and glycosylated hemoglobin (HbA 1c) [(10.63±3.01)%] were high. The average completion rate of the overall data of the first diagnosed patients in SZT1D was only 60% [(62.9±31.5)%]: the number of patients with overall data completion ≥80% in SZT1D was only 50.2%(350/697); the number of patients with overall data completion ≥80% in Shenzhen was less than that outside Shenzhen [44.3%(222/501) vs 65.3%(128/196), P<0.001]. The key indicators with better completion rate of first-visit were disease course [76.2%(531/697)], age of onset [75.8%(528/697)], family history of diabetes [74.9%(522/697)], etc., but none of them had a completion rate of more than 80%, and the diabetes self-management behavior assessment questionnaire and scale score were completely missing; the frequency of daily blood glucose monitoring [46.1%(231/501) vs 64.3%(126/196), P<0.001], current insulin regimen [44.3%(222/501) vs 63.3%(124/196), P<0.001], number of diabetic ketoacidosis (DKA) since the onset of the disease [45.7%(229/501) vs 64.8%(127/196), P<0.001] and the number of symptomatic hypoglycemia in the past 1 month [39.3%(197/501) vs 63.8%(125/196), P<0.001] were higher in Shenzhen than those reported outside Shenzhen. In addition, the probability of abnormal FPG and postprandial glucose (PPG) [5.2%(24/466); 3.8%(19/236)] were low. The revisit rate was not high [17.2%(120/697)], and the revisit rate in Shenzhen was higher than that outside Shenzhen [22.6%(113/501) vs 3.6%(7/196), P<0.001]. The first revisit rate was 16.2%(113/697) and the second revisit rate was seriously insufficient [1.0%(7/697)]. Conclusions:The data quality of T1DM patients recorded by SZT1D needs to be further improved. Improving the information interconnection between China-T1D and SZT1D, employing quality control personnel and building a systematic data quality evaluation analysis and feedback mechanism are methods to promote the comprehensive, accurate and efficient input of T1DM data and continuously improve the evaluation methods to improve the overall data quality.
7.Mechanisms of brain damage caused by inorganic fluoride using proteomics-based techniques
Xiao ZHOU ; Wen WAN ; Dewen JIANG ; Fujun AI ; Ling YE ; Minghai LIU ; Yi ZHANG ; Yanjie LIU
Journal of Environmental and Occupational Medicine 2024;41(1):34-40
Background Chronic excessive exposure to fluoride can cause damage to the central nervous system and a certain degree of learning and memory impairment. However, the associated mechanism is not yet clear and further exploration is needed. Objective Using 4D unlabelled quantitative proteomics techniques to explore differentially expressed proteins and their potential mechanisms of action in chronic excessive fluoride exposure induced brain injury. Methods Twenty-four SPF-grade adult SD rats, half male and half male, were selected and divided into a control group and a fluoride group by random number table method, with 12 rats in each group. Among them, the control group drank tap water (fluorine content<1 mg·L−1), the fluoride group drank sodium fluoride solution (fluorine content 10 mg·L−1), and both groups were fed with ordinary mouse feed (fluoride content<0.6 mg·kg−1). After 180 d of feeding, the SD rats were weighed, and then part of the brain tissue was sampled for pathological examination by hematoxylin-eosin (HE) staining and Nissl staining. The rest of the brain tissue was frozen and stored at −80 ℃. Three brain tissue samples from each group were randomly selected for proteomics detection. Differentially expressed proteins were screened and subcellular localization analysis was performed, followed by Gene Ontology (GO) function analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, cluster analysis, and protein-protein interaction analysis. Finally, Western blotting was used to detect the expression levels of key proteins extracted from the brain tissue samples. Results After 180 d of feeding, the average weight of the rats in the fluoride group was significantly lower than that in the control group (P<0.05). The brain tissue stained with HE showed no significant morphological changes in the cerebral cortex of the fluoride treated rats, and neuron loss, irregular arrangement of neurons, eosinophilic changes, and cell body pyknosis were observed in the hippocampus. The Nissl staining results showed that the staining of neurons in the cerebral cortex and hippocampus of rats exposed to fluoride decreased (Nissl bodies decreased). The proteomics results showed that a total of 6927 proteins were identified. After screening, 206 differentially expressed proteins were obtained between the control group and the fluoride group, including 96 up-regulated proteins and 110 down-regulated proteins. The differential proteins were mainly located in cytoplasm (30.6%), nucleus (27.2%), mitochondria (13.6%), plasma membrane (13.6%), and extracellular domain (11.7%). The GO analysis results showed that differentially expressed proteins mainly participated in biological processes such as iron ion transport, regulation of dopamine neuron differentiation, and negative regulation of respiratory burst in inflammatory response, exercised molecular functions such as ferrous binding, iron oxidase activity, and cytokine activity, and were located in the smooth endoplasmic reticulum membrane, fixed components of the membrane, chloride channel complexes, and other cellular components. The KEGG significantly enriched pathways included biosynthesis of secondary metabolites, carbon metabolism, and microbial metabolism in diverse environments. The results of differential protein-protein interaction analysis showed that the highest connectivity was found in glucose-6-phosphate isomerase (Gpi). The expression level of Gpi in the brain tissue of the rats in the fluoride group was lower than that in the control group by Western blotting (P<0.05). Conclusion Multiple differentially expressed proteins are present in the brain tissue of rats with chronic fluorosis, and their functions are related to biosynthesis of secondary metabolites, carbon metabolism, and microbial metabolism in diverse environments; Gpi may be involved in cerebral neurological damage caused by chronic overdose fluoride exposure.
8.Study on protective effects of Shiyifang medicinal wine on knee osteoarthritis in rabbits based on TLR 4/MyD88/ NF-кB signaling pathway
Wentao ZHANG ; Lingmei ZHOU ; Honghai HUANG ; Huihui BAO ; Dewen MAO ; Hui TIAN ; Shuling LIU
China Pharmacy 2022;33(18):2224-2229
OBJECTIVE To study the protective effect and mechanism of Shiyifang medicinal wine (SYF) on knee osteoarthritis(KOA)of rabbit induced by papain . METHODS Thirty-five rabbits were randomly divided into blank group ,model group,positive group (Diclofenac diethylamine emulsion 200 mg/kg),SYF high -dose group (386 mg/kg)and SYF low -dose group(97 mg/kg),with 7 rabbits in each group (all had 4 males and 3 females). Except for the blank group ,the other groups ’ rabbits were injected 0.5 mL papain mixture (containing 2% papain and 0.03 mol/L L -cysteine)into the right knee cavity on day 1, 4 and 7,to replicate KOA model . Blank group was given constant volume of normal saline . From the 15th day ,drugs were applied to right hind knee joints of rabbits in each group ,twice a day for 20 days. At the same time ,the diameter of right knee joints of rabbits was measured by vernier calipers at day 0,8,14 and 35 to calculate swelling degree . After the experiment ,the levels of IL-1β,TNF-α and PGE 2 in synovial tissue were determined by enzyme -linked immunosorbent assay . Hematoxylin-eosin(HE) staining was used to prepare the sections of synovial tissue ,and the pathological changes were observed . The relative mRNA expressions of TLR 4,MyD88 and NF - кB p 65 in the TLR 4/MyD88/NF- кB signaling pathway were detected by real -time quantitative polymerase chain reaction . The relative protein expressions of TLR 4,MyD88,NF-кB p 65 and p -NF-кB p 65 were detect by Western blot . RESULTS Compared with blank group,the degree of knee swelling could be increased in model group ,the pathological damage of synovial tissue was more serious ,and the levels of IL -1β,TNF-α and PGE 2 were increased significantly in synovial tissue (P<0.05). The relative expression levels of TLR 4,MyD88,NF-кB p 65 mRNAs and TLR 4,MyD88,p-NF-кB p 65 proteins were significantly increased(P<0.05). Compared with model group ,swelling degree of right hind knee and the pathological injury degree of synovial tissue were significantly improved in each treatment group ,while the levels of IL -1β,TNF-α and PGE 2 in synovial tissue were significantly decreased (P<0.05). The relative mRNA expressions of TLR 4,MyD88 and NF -кB p 65 and relative protein expressions of TLR 4,MyD88(except for SYF low -dose group )and p -NF-кB p 65 were all significantly decreased (P<0.05). CONCLUSIONS SYF shows protective effect on KOA induced by papain ,the mechanism of which is associated with decreasing the levels of IL -1β,TNF-α and PGE 2 and down -regulating TLR 4/MyD88/NF-кB signaling pathway .
9.Consensus for the management of severe acute respiratory syndrome.
Nanshang ZHONG ; Yanqing DING ; Yuanli MAO ; Qian WANG ; Guangfa WANG ; Dewen WANG ; Yulong CONG ; Qun LI ; Youning LIU ; Li RUAN ; Baoyuan CHEN ; Xiangke DU ; Yonghong YANG ; Zheng ZHANG ; Xuezhe ZHANG ; Jiangtao LIN ; Jie ZHENG ; Qingyu ZHU ; Daxin NI ; Xiuming XI ; Guang ZENG ; Daqing MA ; Chen WANG ; Wei WANG ; Beining WANG ; Jianwei WANG ; Dawei LIU ; Xingwang LI ; Xiaoqing LIU ; Jie CHEN ; Rongchang CHEN ; Fuyuan MIN ; Peiying YANG ; Yuanchun ZHANG ; Huiming LUO ; Zhenwei LANG ; Yonghua HU ; Anping NI ; Wuchun CAO ; Jie LEI ; Shuchen WANG ; Yuguang WANG ; Xioalin TONG ; Weisheng LIU ; Min ZHU ; Yunling ZHANG ; Zhongde ZHANG ; Xiaomei ZHANG ; Xuihui LI ; Wei CHEN ; Xuihua XHEN ; Lin LIN ; Yunjian LUO ; Jiaxi ZHONG ; Weilang WENG ; Shengquan PENG ; Zhiheng PAN ; Yongyan WANG ; Rongbing WANG ; Junling ZUO ; Baoyan LIU ; Ning ZHANG ; Junping ZHANG ; Binghou ZHANG ; Zengying ZHANG ; Weidong WANG ; Lixin CHEN ; Pingan ZHOU ; Yi LUO ; Liangduo JIANG ; Enxiang CHAO ; Liping GUO ; Xuechun TAN ; Junhui PAN ; null ; null
Chinese Medical Journal 2003;116(11):1603-1635
10.Traditional Chinese Medicine Syndrome Element, Evolutionary Patterns of Patients with Hepatitis B Virus-Related Acute on Chronic Liver Failure at Different Stages: A Multi-Center Clinical Study
Simiao YU ; Kewei SUN ; Zhengang ZHANG ; Hanmin LI ; Xiuhui LI ; Hongzhi YANG ; Qin LI ; Lin WANG ; Xiaozhou ZHOU ; Dewen MAO ; Jianchun GUO ; Yunhui ZHUO ; Xianbo WANG ; Xin DENG ; Jiefei WANG ; Wukui CAO ; Shuqin ZHANG ; Mingxiang ZHANG ; Jun LI ; Man GONG ; Chao ZHOU
Journal of Traditional Chinese Medicine 2024;65(12):1262-1268
ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure (HBV-ACLF) at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients, including 618 in the early stage, 355 in the middle stage, and 85 in the late stage, were collected from 18 clinical centers across 12 regions nationwide from January 1, 2012 to February 28, 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients, like the four diagnostic information (including symptoms, tongue, pulse) of traditional Chinese medicine (TCM), and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients, and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries, including 36 symptom information, 12 tongue information, and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF, which were liver-gallbladder damp-heat pattern, qi deficiency and blood stasis pattern, liver-kidney yin deficiency pattern, and spleen-kidney yang-deficiency pattern. In the early stage, heat (39.4%, 359/912) and dampness (27.5%, 251/912) were most common, and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern (74.6%, 461/618); in the middle stage, dampness (30.2%, 187/619) and blood stasis (20.7%, 128/619) were most common, and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern (53.2%, 189/355), and qi deficiency and blood stasis pattern (27.6%, 98/355); and in the late stage, the pattern of the disease was dominated by qi deficiency (26.3%, 40/152) and yin deficiency (20.4%, 31/152), and the patterns were dominated by qi deficiency and blood stasis pattern (36.5%, 31/85), and liver-gallbladder damp-heat pattern (25.9%, 22/85). ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF, presenting an overall trend of evolving patterns as "from excess to deficiency, transforming from excess to deficiency", which is damp-heat → blood stasis → qi-blood yin-yang deficiency.