1.Tracing Development of LIU Wansu's Theory of ''Fire-heat Inducing Stroke''
Xin LAN ; Changxiang LI ; Haojia ZHANG ; Jialin CHENG ; Zijin SUN ; Liyang DONG ; Zilin REN ; Xueqian WANG ; Fafeng CHENG ; Qingguo WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):32-41
LIU Wansu, as the foremost of the four great masters of the Jin-Yuan period, established the "theory of fire-heat'' and extended the fire-heat pathogenesis framework to the field of stroke, thereby forming the theory of ''fire-heat inducing stroke''. This achieved a paradigmatic shift in stroke etiology from ''exogenous wind inducing stroke'' to ''fire-heat inducing stroke''. This paper systematically reviews the developmental trajectory of LIU Wansu's ''fire-heat inducing stroke'' theory and explores the social background, academic origins, and core connotations of its theoretical construction. The study found that, based on the ''Nineteen Pathomechanisms'' in the Huangdi's Internal Classic (Huang Di Nei Jing) and combined with clinical practice, LIU Wansu proposed that fire-heat is the fundamental cause of stroke, and that the Six Climatic Factors and the Five Zhi-Emotions can all transform into fire. He further constructed a stratified syndrome differentiation and therapeutic system centered on clearing heat and purging fire, emphasizing differentiated treatment of exterior and interior syndromes, Six Meridians syndrome differentiation, and seasonally adjusted medication. This theory not only resolved the diagnostic and therapeutic dilemmas of febrile epidemic diseases during the Jin-Yuan period, but also exerted a profound influence on later physicians such as ZHANG Zihe and ZHU Danxi, thereby promoting the pluralistic development of stroke theory in traditional Chinese medicine (TCM). Modern pharmacological research provides solid scientific evidence, confirming that the ''fire-heat'' pathological state is highly associated with key mechanisms such as excessive inflammatory responses, oxidative stress, and excitatory amino acid toxicity following cerebral ischemia. Heat-clearing and fire-purging prescriptions and agents, such as Huanglian Jiedu Tang and baicalin, can exert multi-target neuroprotective effects by regulating inflammatory signaling, enhancing antioxidant enzyme activity, and balancing neurotransmitters. This not only verifies the scientific basis of the ''fire-heat inducing stroke'' theory from a modern biological perspective but also provides conclusive evidence for the clinical application of heat-clearing and fire-purging therapy. LIU Wansu's ''fire-heat inducing stroke'' theory represents a major milestone in the historical understanding of stroke pathogenesis, and its academically transitional insights continue to hold core guiding value for the pattern identification and treatment of ischemic stroke today.
2.Tracing Development of LIU Wansu's Theory of ''Fire-heat Inducing Stroke''
Xin LAN ; Changxiang LI ; Haojia ZHANG ; Jialin CHENG ; Zijin SUN ; Liyang DONG ; Zilin REN ; Xueqian WANG ; Fafeng CHENG ; Qingguo WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):32-41
LIU Wansu, as the foremost of the four great masters of the Jin-Yuan period, established the "theory of fire-heat'' and extended the fire-heat pathogenesis framework to the field of stroke, thereby forming the theory of ''fire-heat inducing stroke''. This achieved a paradigmatic shift in stroke etiology from ''exogenous wind inducing stroke'' to ''fire-heat inducing stroke''. This paper systematically reviews the developmental trajectory of LIU Wansu's ''fire-heat inducing stroke'' theory and explores the social background, academic origins, and core connotations of its theoretical construction. The study found that, based on the ''Nineteen Pathomechanisms'' in the Huangdi's Internal Classic (Huang Di Nei Jing) and combined with clinical practice, LIU Wansu proposed that fire-heat is the fundamental cause of stroke, and that the Six Climatic Factors and the Five Zhi-Emotions can all transform into fire. He further constructed a stratified syndrome differentiation and therapeutic system centered on clearing heat and purging fire, emphasizing differentiated treatment of exterior and interior syndromes, Six Meridians syndrome differentiation, and seasonally adjusted medication. This theory not only resolved the diagnostic and therapeutic dilemmas of febrile epidemic diseases during the Jin-Yuan period, but also exerted a profound influence on later physicians such as ZHANG Zihe and ZHU Danxi, thereby promoting the pluralistic development of stroke theory in traditional Chinese medicine (TCM). Modern pharmacological research provides solid scientific evidence, confirming that the ''fire-heat'' pathological state is highly associated with key mechanisms such as excessive inflammatory responses, oxidative stress, and excitatory amino acid toxicity following cerebral ischemia. Heat-clearing and fire-purging prescriptions and agents, such as Huanglian Jiedu Tang and baicalin, can exert multi-target neuroprotective effects by regulating inflammatory signaling, enhancing antioxidant enzyme activity, and balancing neurotransmitters. This not only verifies the scientific basis of the ''fire-heat inducing stroke'' theory from a modern biological perspective but also provides conclusive evidence for the clinical application of heat-clearing and fire-purging therapy. LIU Wansu's ''fire-heat inducing stroke'' theory represents a major milestone in the historical understanding of stroke pathogenesis, and its academically transitional insights continue to hold core guiding value for the pattern identification and treatment of ischemic stroke today.
3.Analysis of knowledge related to human papillomavirus and vaccination willingness among college students in Guizhou Province
REN Li, WU Yuqian, ZHU Liwan,LI Fenxiang, FAN Shujun, GAN Jianzhe, DONG Shuwen, LU Yong
Chinese Journal of School Health 2026;47(2):212-216
Objective:
To explore human papillomavirus (HPV) and vaccination related knowledge and vaccination willingness of college students in Guizhou Province and their related factors, so as to provide a basis for formulating targeted intervention strategies.
Methods:
From May to June 2025, by applying convenience sampling method,4 567 college students were selected from 8 universities in Guizhou Province to conduct a questionnaire survey. Awareness of HPV and vaccination related knowledge, vaccination willingness as well as related factors among college students were also analyzed. The t test and Chi square test were used for comparison between groups, and multifactor Logistic regression was employed to analyze the related factors of HPV vaccination willingness among college students.
Results:
The HPV and vaccine knowledge score of college students in Guizhou Province was ( 10.50 ±2.09), and the score of girls (10.81±1.82) was higher than that of boys (10.19±2.30) ( t=10.09, P <0.01). The HPV vaccination willingness rate of college students was 65.6%, and the rate was higher in girls than in boys (67.1%,64.1%, χ 2=4.75, P <0.05). Multi factor Logistic regression analysis showed that ethnicity and HPV testing were related factors that affected college students willingness to vaccinate (minority: OR boy =1.23, OR girl =1.35; previous HPV testing: OR boy =0.56, OR girl =0.59); boys willingness to vaccinate was related to the number of sexual partners ( OR =0.60), family history of cancer ( OR =0.65), and sexual behavior related HPV knowledge scores ( OR =0.89), while girls willingness to vaccinate was related to bisexual sexual orientation ( OR =0.59), previous HIV testing ( OR =0.60), and HPV and vaccine basic knowledge scores ( OR =0.86) (all P <0.05).
Conclusions
College students in Guizhou Province have higher HPV vaccine related knowledge scores and are more willing to vaccinate, and those above are higher in girls than in boys. Health education content should be optimized based on gender differences, and promote the willingness and behavior of HPV vaccination among college students.
4.Mechanisms of Xiaozhi Qinggan Decoction in Treatment of Metabolic Dysfunction-associated Steatotic Liver Disease by Regulating Ferroptosis
Haihang DONG ; Yuying TU ; Xingrong LI ; Yujie CAI ; Yi REN ; Huiqin ZHANG ; Yinqiang ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):109-119
ObjectiveTo investigate the mechanism of Xiaozhi Qinggan decoction (XQD) in preventing and treating metabolic dysfunction-associated steatotic liver disease (MASLD) by regulating ferroptosis, network pharmacology, in vitro and in vivo experiments. MethodsIn the in vivo experiment, mouse MASLD models were established by high-fat diet (HFD) induction. The model mice were randomly assigned to a positive control group (silybin, 50 mg·kg-1), low-, medium- and high-dose XQD groups (4.725, 9.45, 18.9 g·kg-1), with a normal control group. After 4 weeks of modeling, mice except the normal group were administered intragastrically for 8 consecutive weeks. Liver function, serum lipid levels, hepatic histopathology, as well as the levels of malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH) and oxidized glutathione (GSSG) and Fe2+ were detected. The mRNA and protein expression of p53, SLC7A11 and GPX4 were determined by quantitative Real-time quantitative polymerase chain reaction(Real-time PCR) and Western blot. In the network pharmacology analysis, active components and potential targets of XQD for MASLD were screened, followed by functional and pathway enrichment analyses, and molecular docking was performed to verify the target binding activity. In the in vitro experiment, the optimal concentration of XQD-containing serum was screened by cytotoxicity assay. HepG2 cells were transfected with ov-NC or ov-p53 plasmid, and a lipid accumulation model was induced by free fatty acid (FFA, 1.0 mmol·L-1). Cells were divided into a normal group, FFA model group, ov-NC+XQD (15%) group and ov-p53+XQD (15%) group. Intracellular Fe2+ level and lipid accumulation were evaluated, and the protein expression of p53, SLC7A11 and GPX4 was measured by Western blot. ResultsCompared with the normal group, the model group exhibited markedly elevated body weight, liver weight, liver index, fasting blood glucose, AUC of glucose tolerance test, serum liver function and blood lipid levels at week 12 (P<0.01). Hepatic steatosis and inflammatory infiltration were observed by pathological staining. Additionally, hepatic levels of MDA, SOD and Fe2+ were increased (P<0.01), while GSH, GSSG and the GSH/GSSG ratio were decreased (P<0.01). The mRNA and protein expression of hepatic p53 was upregulated (P<0.01), whereas the expression of SLC7A11 and GPX4 was downregulated (P<0.01). Compared with the model group, the low- and medium-dose XQD groups showed significantly decreased body weight at week 12 (P<0.05). The silybin group, together with the medium- and high-dose XQD groups, presented reduced liver weight and liver index (P<0.05). Fasting blood glucose and the AUC of glucose tolerance test were lowered in all four treatment groups (P<0.05, P<0.01). Pathological staining revealed alleviated hepatic steatosis and inflammation, accompanied by decreased serum liver function and blood lipid levels (P<0.05, P<0.01). Moreover, hepatic MDA and SOD levels were markedly reduced, while GSH, GSSG and the GSH/GSSG ratio were significantly elevated (P<0.05, P<0.01). Hepatic Fe2+ level was decreased (P<0.01). The mRNA and protein expression of hepatic p53 was downregulated, and the expression of SLC7A11 and GPX4 was upregulated (P<0.05, P<0.01). Network pharmacology analysis identified quercetin, kaempferol, luteolin, tanshinone IIA and isorhamnetin as the core active components of XQD, with p53 serving as the key target. Stable binding was verified between these active components and the p53 protein. The optimal concentration of XQD-containing serum in vitro was determined to be 15%. Compared with the normal group, the model group showed increased intracellular Fe2+ and lipid accumulation, significantly upregulated p53 protein expression (P<0.01), and markedly downregulated SLC7A11 and GPX4 protein expression (P<0.01). Compared with the model group, the ov-NC group exhibited reduced Fe2+ and lipid accumulation, downregulated p53 expression, and upregulated SLC7A11 and GPX4 expression. In the ov-p53 group, p53 expression was upregulated (P<0.01), while SLC7A11 and GPX4 expression was downregulated (P<0.01). ConclusionXQD inhibits ferroptosis by downregulating p53 and upregulating SLC7A11 and GPX4, thereby alleviating oxidative stress and lipid peroxidation in hepatocytes and improving MASLD.
5.Expert consensus on the clinical application of domestic ultra-high-definition medical endoscopes in cardiovascular surgery (2026 edition)
Junfei ZHAO ; Biaochuan HE ; Yun TENG ; Xiaohua LI ; Zerui CHEN ; Chungeng LIU ; Yijiu REN ; Chang CHEN ; Nianguo DONG ; Jimei CHEN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):857-865
This consensus focuses on the clinical application of domestic ultra-high-definition (UHD) medical endoscopes in cardiovascular surgery, addressing their clinical value, key technical aspects, and strategies for broader implementation. It traces the evolution of domestic endoscopic platforms from high-resolution imaging toward integrated advanced functionalities such as fluorescence imaging, three-dimensional visualization, and intelligent assistance. The document outlines standardized procedural steps and perioperative management pathways for minimally invasive endoscopic cardiovascular surgery and summarizes specific application scenarios and technical considerations in congenital heart disease, valvular disorders, coronary artery disease, arrhythmias, and cardiac tumors. Furthermore, recommendations are provided regarding professional training, multicenter collaboration, the establishment of clinical evaluation systems, and coordinated policy-industry support to promote standardized adoption and high-quality dissemination of domestic medical devices. Based on available evidence and expert agreement, 16 consensus statements are presented, aiming to offer authoritative and actionable guidance for clinical practice.
6.Compatibility of commonly used intravenous drugs in ICU patients with severe pneumonia
Lei ZHANG ; Xiao LI ; Jing WANG ; Xiaokai REN ; Zhanjun DONG
China Pharmacy 2026;37(14):1886-1891
OBJECTIVE To quantitatively assess the compatibility risk of commonly used intravenous drugs in intensive care unit (ICU) patients with severe pneumonia, and provide a reference for reducing the incidence of adverse events caused by incompatibility. METHODS The PASS clinical pharmacy management system was used to retrospectively collect the data of patients diagnosed with “severe pneumonia” in the ICU of Hebei General Hospital from January 2023 to June 2025, and the commonly used intravenous drugs and medication frequency were extracted. Based on authoritative databases such as Micromedex and Stabilis as well as relevant literature, the compatibility data of commonly used intravenous drugs with 0.9% Sodium chloride injection and 5% Glucose injection were summarized. The theoretical and actual compatibility risk values were calculated using formulas, and high-risk drugs were screened and the compatibility query table was drawn. RESULTS A total of 158 ICU patients with severe pneumonia were treated with 89 intravenous drugs, and 24 drugs with high compatibility risk were identified. The drug with the highest theoretical compatibility risk value was Amphotericin B for injection (risk value 146), and the drug with the highest actual compatibility risk value was Propofol medium and long chain fat emulsion injection (risk value 8 740). Among the 24 high-risk drugs, six drugs, namely Esomeprazole sodium for injection, Ambroxol hydrochloride injection, Midazolam injection, Methylprednisolone sodium succinate for injection, Furosemide injection, and Cefoperazone sodium and sulbactam sodium for injection, simultaneously ranked among the top 15 in both theoretical and actual compatibility risk rankings. Among 650 pairwise compatibility combinations of the 24 drugs, 24.62% were compatible, 11.23% were incompatible, 6.77% had conflicting evidence, and 57.38% had missing evidence. CONCLUSIONS This study quantitatively analyzed the medication safety of commonly used intravenous drugs in ICU patients with severe pneumonia, identified 24 drugs with high compatibility risk, and established a compatibility query table for high-risk drugs, which helps reduce the risk of ICU compatibility adverse events.
7.Effect of baicalein on high glucose-induced pyroptosis in cardiac fibroblasts
Zhengrong XU ; Xueqi DONG ; Qian SUN ; Huiying LIU ; Wenjuan DENG ; Weidong REN ; Jun GU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(8):1076-1081
Objective To determine the effect of baicalein on high glucose-induced cardiac fibro-blast pyroptosis based on the nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)/cysteinyl aspartate-specific proteinase-1(Caspase-1)/gasdermin D(GSDMD)pathway.Methods Rat cardiac fibroblasts were grouped into control,high glucose group,low-,medium-and high-dose baicalein(H-,M-and L-baicalein)groups,and H-baicalein+NLRP3 agonist(BMS-986299)group.Except for the control group,all other groups were cultured in DMEM medium containing 40 mmol/L glucose,then 12.5,25 and 50 μmol/L baicalein was added into the medium correspondingly,and 1 μmol/L BMS-986299 was used to treat the H-baicalein+NLRP3 agonist group.Lactate dehydrogenase(LDH)cytotoxicity assay were employed to detect cell cytotoxicity.qRT-PCR and Western blotting were performed to determine the expression of NLRP3,Caspase-1,and GSDMD at mRNA and protein levels.Results High glucose treatment induced more EdU positive cells,higher pyroptotic rate,stronger cytotoxicity,higher Col-Ⅰ and Col-Ⅲ contents,and enhanced mRNA and protein levels of NLRP3,Caspase-1 and GSDMD in comparison to the control group(P<0.05).The H-baicalein+NLRP3 agonist group had more EdU positive cells(26.85±2.95 cells vs 15.43±1.82 cells,P<0.05),higher pyroptotic rate[(33.45±4.02)%vs(17.34±2.15)%,P<0.05],stronger cytotoxicity[(27.94±2.93)%vs(14.13±1.87)%,P<0.05],and increased contents of Col-Ⅰ(107.58±13.39 ng/ml vs 58.73±8.36 ng/ml,P<0.05)and Col-Ⅲ(118.43±13.95 ng/ml vs 68.74±8.57 ng/ml,P<0.05),and enhanced expression of NLRP3,Caspase-1 and GSDMD at both mRNA and protein levels(P<0.05)when compared with the H-baicalein group.Conclusion Baicalein inhibits high glucose-induced cardiac fibroblast pyroptosis by suppressing NLRP3/Caspase-1/GSDMD pathway.
8.Modulation of cardiac inflammation by Qifu Yixin Granules in rats with heart failure via TLR4/MyD88/NF-κB signaling pathway
Qian-rong LI ; Xiao-dong ZHI ; Bing JIANG ; Chun-ling WANG ; Chun-zhen REN ; Xin-ke ZHAO ; Kai LIU ; Ying-dong LI
Chinese Traditional Patent Medicine 2025;47(8):2535-2541
AIM To investigate the effects of Qifu Yixin Granules on cardiac inflammation in a rat model of heart failure.METHODS The rats were induced into chronic heart failure(CHF)models by 6-week intraperitoneal injection of doxorubicin followed by the random assignment of the successful rat models into the model group,the captopril group(22.5 mg/kg),and the low-dose,medium-dose,and high-dose Qifu Yixin Granules groups(2.84,5.67,11.34 g/kg),in contrast to the normal rats of the blank group.The rats had their body weight monitored;their cardiac function assessed by echocardiography;their serum levels of NT-proBNP,TNF-α,IL-6,IL-1 and CRP measured by ELISA;their cardiac morphological alterations observed by HE and Masson staining;their cardiac protein expressions of TLR4,MyD88 and NF-κB detected by immunohistochemistry and Western blot;and their cardiac mRNA expressions of TLR4,MyD88 and NF-κB measured by RT-qPCR.RESULTS Compared to the blank group,the model group exhibited significantly reduced body weight,LVEF and LVFS(P<0.01),alongside significantly elevated LVEDD,LVESD,and serum concentrations of NT-proBNP,TNF-α,IL-6,IL-1 and CRP(P<0.01).Additionally,the model group displayed greater myocardial inflammatory cell aggregation,increased collagen deposition(P<0.01);and upregulated myocardial protein and mRNA expressions of TLR4,MyD88 and NF-κB(P<0.01).Compared to the model group,the groups intervened with captopril or medium/high dose Qifu Yixin Granules demonstrated significantly increased body weight,LVEF and LVFS(P<0.05,P<0.01);significantly reduced LVEDD,LVESD,and serum levels of the aforementioned indicators(P<0.05,P<0.01);mitigated inflammation and collagen deposition(P<0.05,P<0.01);and downregulated myocardial protein and mRNA expressions of TLR4,MyD88 and NF-κB(P<0.05,P<0.01).CONCLUSION Qifu Yixin Granules attenuate cardiac inflammation and improve cardiac function in doxorubicin-induced CHF rats;this therapeutic effect is mediated by inhibiting the activation of the TLR4/MyD88/NF-κB signaling pathway.
9.Value of abnormal expression of serum alpha fetoprotein variant 3 and β2 microglobulin in predicting complications after interventional surgery in patients with liver cancer
Liangliang MA ; Kai HUANG ; Li LI ; Dongxiao REN ; Shujian GAO ; Shenming DONG
International Journal of Laboratory Medicine 2025;46(8):921-925
Objective To analyze the value of abnormal expression of serum alpha fetoprotein variant 3(AFP-L3)and β2 microglobulin(β2-MG)in predicting complications after interventional surgery in patients with liver cancer.Methods Clinical information of totally 92 patients with liver cancer who underwent inter-ventional surgery in the hospital from January 2020 to December 2023 were retrospectively collected and the patients were divided into complication group(33 cases)and non-complication group(59 cases)according to whether complications occurred after interventional surgery.The levels of AFP-L3 and β2-MG were detected respectively.Multivariate Logistic regression was used to analyze the the factors influencing the occurrence of complications in patients with liver cancer.Receiver operating characteristic(ROC)curve was used to evaluate the val-ue of the levels of AFP-L3 and β2-MG to predict complications in patients with liver cancer.Results Compared with the non-complication group,the proportion of patients with a history of diabetes,positive hepatitis B vi-rus(HBV)-DNA,poorly differentiated histology,and the levels of AFP-L3 and β2-MG were higher in the complication group(P<0.05),and the course of liver cancer was longer(P<0.05).Multivariate Logistic re-gression analysis showed that the levels of AFP-L3 and β2-MG were independent risk factors for complications after interventional surgery in patients with liver cancer.The area under the curve(AUC)of AFP-L3 and β2-MG levels in predicting complications after interventional surgery in patients with liver cancer were 0.874 and 0.854,respectively,with sensitivity of 89.77%and 74.79%,and specificity of 87.21%and 84.82%,respec-tively.The cut off values were 92.281 μg/L and 4.430 mg/L,respectively.The AUC of the combination of AFP-L3 and β2-MG levels in predicting postoperative complications was 0.910,which was significantly better than the predictive value of the single indicator(P<0.05).Conclusion High levels of serum AFP-L3 and β2-MG may be independent risk factors for complications after interventional surgery in patients with liver canc-er.The combined detection of the two serum indicators has higher predictive value for postoperative complica-tions.It provides a new means to evaluate complications in patients with liver cancer after interventional sur-gery.
10.Correlation between serum MIF,25(OH)D and cognitive function in patients with vestibular migraine
Xiao JIN ; Yanhong WANG ; Lianqi YANG ; Dong ZHANG ; Yong LI ; Zhihua REN ; Caihong WANG
Tianjin Medical Journal 2025;53(11):1175-1179
Objective To explore the correlation between serum macrophage migration inhibitory factor(MIF),25-hydroxyvitamin D[25(OH)D]and cognitive function in patients with vestibular migraine(VM).Methods A total of 200 patients with VM were selected and used as the VM group.Based on the Montreal Cognitive Assessment(MoCA)criteria,patients were divided into the cognitively normal group(128 cases)and the cognitively impaired group(72 cases).Additionally,200 healthy individuals undergoing routine health examination were selected as the control group.Serum MIF and 25(OH)D levels were measured using enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze influencing factors of cognitive impairment in VM patients.The value of serum MIF and 25(OH)D levels in diagnosing cognitive impairment in patients with VM was analyzed by using the receiver operating characteristic(ROC)curve.Results The serum MIF was higher in the VM group than that of the control group,and serum 25(OH)D was lower in the VM group(P<0.05).The serum MIF was higher in the cognitive impairment group than that of the cognitive normal group,while the serum 25(OH)D was lower in the cognitive impairment group than that of the cognitive normal group(P<0.05).Multivariate Logistic regression found that increased serum MIF level and decreased 25(OH)D level were independent risk factors for cognitive impairment in VM patients(P<0.05).ROC curve analysis showed that the AUC(95%CI)of the combined diagnosis of cognitive impairment in VM patients using serum MIF and 25(OH)D levels was 0.900(0.850-0.938),which was higher than that of MIF diagnosed alone[0.797(0.735-0.851)]and 25(OH)D alone[0.817(0.756-0.868),P<0.05].Conclusion VM patients with cognitive impairment have elevated serum MIF levels and decreased 25(OH)D levels.The combined diagnostic value of the two markers has a relatively high value for VM patients with cognitive impairment.


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