1.Herbal Textual Research on Longan Arillus in Famous Classical Formulas
Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):300-309
This article systematically analyzed the historical evolution of the name, origin, harvesting and others of Longan Arillus by referring to the ancient and modern literature, in order to provide a foundation for developing famous classical formulas containing this herb. After textual research, it indicated that Longan Arillus was first recorded under the name of longan in Shennong Bencaojing of the Han dynasty. During the Ming and Qing dynasties, Longan Arillus gradually replaced longan as the standard name recorded in the materia medica, with additional aliases including Yizhi, Lizhinu and Yuanyan. The source of Longan Arillus used in the past dynasties was the arillus of the Sapindaceae plant Dimocarpus longan. The production regions recorded in the past dynasties were mainly Fujian, Guangdong, Guangxi, Hainan, Sichuan and others. Since the Qing dynasty, Longan Arillus produced in Fujian, Guangdong and Guangxi have been regarded as the finest and authentic varieties, with Fujian, Guangxi, and Guangdong remaining the primary authentic production areas today. In ancient times, the fruits were primarily harvested in August of the lunar calendar. However, modern longan cultivation typically involves harvesting ripe fruits during summer and autumn. Post-harvest processing involves removing moisture through sun-drying or baking before drying for medicinal use. Throughout history, processing methods have primarily focused on raw product, though techniques such as wine soaking and powdering have also been employed. Since modern times, it has been concluded that its quality is the best one with thick flesh, sweet taste, brownish-yellow color and tender texture. Longan Arillus possesses a sweet and warm nature, entering the heart and spleen meridians. Its primary functions are tonifying the heart and spleen, nourishing the blood and calming the spirit, which is consistent in ancient and modern times. Based on the textual research, it is suggested to use the arillus of D. longan when developing the famous classical formulas containing Longan Arillus. Processing methods should be selected according to the formula requirements, where no specific processing is indicated, the raw products is recommended for medicinal use.
2.Ionizing Radiation-induced Lens Injury: Epidemiology, Dose-effect Relationship, and Molecular Mechanisms
Cheng-Hao HU ; Shao-Han REN ; Hai-Tao ZHANG ; Jing-Ming ZHAN
Progress in Biochemistry and Biophysics 2026;53(3):688-696
The crystalline lens of the eye is recognized as one of the most radiosensitive tissues in the human body. While the International Commission on Radiological Protection (ICRP) has classified ionizing radiation (IR)-induced cataracts as a tissue reaction (deterministic effect) and subsequently reduced the occupational equivalent dose limit for the lens, significant uncertainties remain regarding the precise dose threshold and the complex biological pathways driving lens opacification. This review provides a comprehensive synthesis of current knowledge concerning radiation-induced lens damage, integrating epidemiological exposure characteristics with dose-response modeling and mechanistic molecular insights. First, we analyze exposure characteristics through four epidemiological dimensions: dose, time, space, and population. Clinical evidence suggests that radiation cataracts—particularly posterior subcapsular opacities—exhibit a distinct latency period that is inversely correlated with dose. We highlight that risk is not confined to acute high-dose scenarios (such as in atomic bomb survivors) but is increasingly relevant in chronic low-dose occupational settings (e.g., interventional radiology) and medical diagnostics (e.g., CT scans). Crucially, individual susceptibility is modified by genetic background, age, and environmental co-factors, complicating risk assessment. Second, we critically examine the dose-effect relationship. Although the ICRP suggests a threshold of 0.5 Gy, emerging data challenge the traditional threshold model, with some studies advocating for a linear non-threshold (LNT) relationship. We further discuss the critical roles of radiation quality and dose rate. High linear energy transfer (LET) radiation demonstrates a significantly higher relative biological effectiveness (RBE) for cataractogenesis compared to low-LET radiation. Paradoxically, and unlike many other tissues, the lens may exhibit an “inverse dose-rate effect,” where fractionated or protracted exposures potentially enhance biological damage—a finding that challenges classical radiobiological paradigms. Third, drawing upon the “cataractogenic load” hypothesis and the unique physiological constraints of the lens, this review elucidates the multidimensional molecular mechanisms driving radiation-induced opacification. Key mechanisms include four aspects. (1) DNA damage and repair: IR induces DNA double-strand breaks (DSBs) that, due to the lens’ limited repair capacity (modulated by genes such as ATM, Ptch1, and Ercc2), lead to the accumulation of damage. (2) Antioxidant defense system: dysfunction of the Nrf2/HO-1 antioxidant axis results in redox imbalances, triggering NF-κB-mediated inflammation and protein aggregation. (3) Cell proliferation and senescence: IR disrupts cell cycle regulation, causing a dichotomy of effects—driving premature senescence in some cell populations (evidenced by ATM nuclear foci) while inducing aberrant proliferation via growth factor upregulation (FGF2, TGFβ) in others. (4) Cell migration and adhesion: activation of the Wnt/β‑catenin pathway and alterations in the E-cadherin complex promote the abnormal migration of epithelial cells to the posterior capsule, a hallmark of radiation-induced cataracts. In conclusion, radiation-induced cataractogenesis is a multifactorial process in which genetic susceptibility and environmental stressors converge to overwhelm the lens’ homeostatic thresholds. Future research must prioritize longitudinal cohort studies to refine dose thresholds and employ multi-omics approaches to map the crosstalk between DNA damage responses and matrix remodeling. Establishing a robust mechanistic model is essential for developing targeted radioprotective strategies and optimizing radiation protection standards for occupational and medical safety.
3.Literature analysis of euglycemic diabetic ketoacidosis induced by empagliflozin
Zhenzhen LEI ; Wei RUI ; Yanling SHI ; Jiayue ZHU ; Ying GANG ; Xiaodi SUN ; Hao ZHAN ; Junnan WANG ; Yukun NIU ; Wenxiang ZHANG
China Pharmacy 2026;37(14):1874-1879
OBJECTIVE To investigate the clinical characteristics of euglycemic diabetic ketoacidosis (euDKA) induced by empagliflozin, and provide references for safe medication. METHODS Case reports of euDKA induced by empagliflozin were retrieved and analyzed from PubMed, Web of Science, CNKI, and Wanfang Data. The Naranjo’s scale was adopted to assess the causal relationship between empagliflozin and euDKA. RESULTS A total of 29 patients were enrolled, including 16 males and 13 females,with a median age of 58 years. All patients were diagnosed with type 2 diabetes mellitus; 22 patients had at least one comorbidity. The median time to euDKA onset was 60 days after administration, and 7 cases occurred within 2 weeks of treatment. Perioperative periods,fasting,and low-carbohydrate or ketogenic diets were the main predisposing factors. Common presentations included nausea,vomiting, fatigue, tachypnea,and tachycardia. The causal relationship between empagliflozin and euDKA was assessed as “probable” in all cases. According to adverse reaction severity grading, 13 cases were grade 3 (severe) and 16 cases were grade 4 (life-threatening). All patients discontinued empagliflozin and recovered after corresponding treatment. CONCLUSIONS euDKA is a serious adverse reaction to empagliflozin, which mostly occurs early in treatment. Perioperative periods, fasting, and ketogenic diets are prone to induce euDKA. Elderly patients and those with comorbidities are at higher risk. Risk assessment should be conducted before clinical administration; blood ketones and acid-base monitoring should be strengthened in the early medication period; withhold the drug before elective surgery, avoid prolonged fasting;upon diagnosis, discontinue empagliflozin and initiate intravenous insulin, provide fluid resuscitation promptly, and use other treatments to improve patient prognosis.
4.Herbal Textual Research on Spatholobi Caulis in Famous Classical Formulas
Yajie XIANG ; Yangyang LIU ; Jian FENG ; Chun YAO ; Erwei HAO ; Wenlan LI ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):238-248
Through consulting herbal medicine, medical books, and local chronicles from past dynasties to modern times, this paper systematically researched Spatholobi Caulis from name, origin, producing areas, harvesting, processing, usage, quality evaluation, functions and indications, providing a reference for the development and utilization of famous classical formulas containing Spatholobi Caulis. According to the research, Spatholobi Caulis was first recorded in the Annals of Shunning Prefecture from the Qing dynasty. It was originally a medicinal herb commonly used in Shunning, Yunnan, and was named from the red juice resembling chicken blood that flowed out after the vein was cut off. The mainstream original plants of each dynasty were Kadsura heteroclita and Spatholobus suberectus. Among them, K. heteroclita mainly focused on dispersing blood stasis and unblocking meridians, mainly treating rheumatic pain and injuries caused by falls or blows, and it is mostly used as the raw material of Jixueteng ointments. S. suberectus was commonly used as decoction pieces in decoction, which had the functions of promoting blood circulation and replenishing blood, activating meridians and collaterals, and mainly used for treating anemia, irregular menstruation, and rheumatic bone pain. The production area of Spatholobi Caulis recorded in the Qing dynasty was Yunnan. Currently, the main production area of S. suberectus is Guangxi, while the main production area of K. interior is Yunnan. In the Qing dynasty, the usage of Spatholobi Caulis was an individual prescription with other herbs before making ointments, which was usually composed of the juice of it, safflower, angelica, and glutinous rice. But in modern times, Spatholobi Caulis is mostly sliced and dried for use. The quality of Spatholobi Caulis is often determined by the number of reddish-brown concentric circles on the cut surface, with a higher number indicating better quality. Additionally, the presence of resinous secretions is also considered desirable. Based on the research findings, it is suggested that when developing famous classical formulas containing Spatholobi Caulis, the choice of the primary source should be S. suberectus or K. heteroclita, taking into consideration the therapeutic effects of the formula. It is also recommended that the latest plant classification be referenced in the next edition of Chinese Pharmacopoeia, adjusting the primary source of Kadsurae Caulis to K. heteroclita to avoid confusion caused by inconsistent original names, and the functions adjust to promote Qi circulation and relieve pain, disperse blood stasis and unblock collaterals, treating injuries caused by falls and bruises.
5.Herbal Textual Research on Abri Herba and Abri Mollis Herba in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):193-201
This article systematically analyzes the historical evolution of the name, origin, academic name, medicinal parts, origin, harvesting, processing and other aspects of Abri Herba and Abri Mollis Herba by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the modern literature, so as to provide a basis for the development of famous classical formulas containing this type of medicinal materials. According to the herbal textual research, Abri Herba was first recorded in Lingnan Caiyaolu, with other aliases such as Huangtoucao and Xiye Longlincao. It originates from the dried whole plant of Abrus cantoniensis, a Fabaceae plant, which can be used medicinally except for its fruits. Currently, this species is mainly distributed in Guangdong and Guangxi, and also found in Hunan and Thailand, it can be harvested throughout the year, mainly in spring and autumn. The roots, stems, and leaves can be used for medicinal purposes, but the pods are toxic and need to be removed. After harvesting, impurities and pods are removed, and it is dried and processed for medicinal use. Abri Herba has a sweet and slightly bitter taste, is cool in nature, and is associated with the liver and stomach meridians, it is used for clearing heat and relieving dampness, dispersing blood stasis and relieving pain, and is mainly used to treat jaundice-type hepatitis, stomach pain, rheumatic bone pain, contusion and ecchymosis pain, and mastitis. Abri Mollis Herba was first recorded in the 1982 edition of Zhongyaozhi as another origin for Abri Herba, and was singled out in some monographs such as Xinhua Bencao Gangyao in 1988 for use, while some other monographs use it as a local habitual products or confused products of Abri Herba with aliases such as Daye Jigucao, Qingtingteng, and Maoxiangsi. It comes from the dried whole herb of A. mollis without pods, and is mainly produced in Guangxi and Guangdong, and occasionally found in Hong Kong, Hainan and Fujian. The collection and processing are similar to Abri Herba, after harvesting, impurities and pods are removed, and it is dried and cut for medicinal use. Abri Mollis Herba has a sweet and light taste, is cool in nature, and is associated with the liver and stomach meridians, with the efficacy of clearing heat and detoxifying, and promoting dampness, it is mainly used to treat infectious hepatitis, mastitis, furuncles, burns and scalds, and pediatric malnutrition. Based on the research, A. mollis was first recorded to be used as a medicine in the same origin as A. cantoniensis, and as plants of the same genus, have similar morphological characteristics, and their medicinal parts, collection and processing, properties and flavors, and meridian affiliations are consistent. And in the folk, Abri Mollis Herba is often used as Abri Herba, which has been used for a long time and is now dominated by the cultivation of A. mollis. So it is recommended that the subsequent version of Chinese Pharmacopoeia should include A. mollis in the origin of Abri Herba, and it is also recommended that in famous classical formulas refered to Jiguccao can use A. cantoniensis and A. mollis as the sources of the herb, refered to Mao Jiguccao can use A. mollis as the sources of the herb. Processing is carried out according to the requirements specified in the original formulas, and raw products are recommended to be included in the medicine if there are no requirements.
6.Herbal Textual Research on Abri Herba and Abri Mollis Herba in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):193-201
This article systematically analyzes the historical evolution of the name, origin, academic name, medicinal parts, origin, harvesting, processing and other aspects of Abri Herba and Abri Mollis Herba by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the modern literature, so as to provide a basis for the development of famous classical formulas containing this type of medicinal materials. According to the herbal textual research, Abri Herba was first recorded in Lingnan Caiyaolu, with other aliases such as Huangtoucao and Xiye Longlincao. It originates from the dried whole plant of Abrus cantoniensis, a Fabaceae plant, which can be used medicinally except for its fruits. Currently, this species is mainly distributed in Guangdong and Guangxi, and also found in Hunan and Thailand, it can be harvested throughout the year, mainly in spring and autumn. The roots, stems, and leaves can be used for medicinal purposes, but the pods are toxic and need to be removed. After harvesting, impurities and pods are removed, and it is dried and processed for medicinal use. Abri Herba has a sweet and slightly bitter taste, is cool in nature, and is associated with the liver and stomach meridians, it is used for clearing heat and relieving dampness, dispersing blood stasis and relieving pain, and is mainly used to treat jaundice-type hepatitis, stomach pain, rheumatic bone pain, contusion and ecchymosis pain, and mastitis. Abri Mollis Herba was first recorded in the 1982 edition of Zhongyaozhi as another origin for Abri Herba, and was singled out in some monographs such as Xinhua Bencao Gangyao in 1988 for use, while some other monographs use it as a local habitual products or confused products of Abri Herba with aliases such as Daye Jigucao, Qingtingteng, and Maoxiangsi. It comes from the dried whole herb of A. mollis without pods, and is mainly produced in Guangxi and Guangdong, and occasionally found in Hong Kong, Hainan and Fujian. The collection and processing are similar to Abri Herba, after harvesting, impurities and pods are removed, and it is dried and cut for medicinal use. Abri Mollis Herba has a sweet and light taste, is cool in nature, and is associated with the liver and stomach meridians, with the efficacy of clearing heat and detoxifying, and promoting dampness, it is mainly used to treat infectious hepatitis, mastitis, furuncles, burns and scalds, and pediatric malnutrition. Based on the research, A. mollis was first recorded to be used as a medicine in the same origin as A. cantoniensis, and as plants of the same genus, have similar morphological characteristics, and their medicinal parts, collection and processing, properties and flavors, and meridian affiliations are consistent. And in the folk, Abri Mollis Herba is often used as Abri Herba, which has been used for a long time and is now dominated by the cultivation of A. mollis. So it is recommended that the subsequent version of Chinese Pharmacopoeia should include A. mollis in the origin of Abri Herba, and it is also recommended that in famous classical formulas refered to Jiguccao can use A. cantoniensis and A. mollis as the sources of the herb, refered to Mao Jiguccao can use A. mollis as the sources of the herb. Processing is carried out according to the requirements specified in the original formulas, and raw products are recommended to be included in the medicine if there are no requirements.
7.Impact of competition-induced mental fatigue on cognitive abilities and electrocardiographic features
Chuantao LI ; Zhan CHEN ; Wei JIANG ; Zhiyuan CHEN ; Hao YU
Academic Journal of Naval Medical University 2025;46(6):751-759
Objective To look for cognitive assessment paradigms and electrocardiographic(ECG)characteristics sensitive to mental fatigue through an experimental study.Methods Data were collected from 10 healthy students of the University of Shanghai for Science and Technology who participated in the 4-day National Undergraduate Electronics Design Contest,including their Stanford sleepiness scale(SSS)scores,sleep duration,cognitive task performance,and ECG signal data.Ten ECG features,including time-domain,frequency-domain,and information-domain characteristics,were extracted during cognitive tasks.The cognitive task performance and ECG features sensitive to changes in mental fatigue were analyzed.Results Significant differences were observed in SSS scores(x2=23.116,P<0.001)and sleep duration(x2=19.608,P<0.001)across the 4 d.For cognitive task performance,word-color congruent accuracy and word-color incongruent accuracy in the Stroop task and Single-visual target stimulus accuracy and Visual target-auditory non-target stimulus accuracy in the audiovisual competition task all showed significant negative correlations with SSS scores(all P<0.05).Regarding ECG features,Poincaré plot SD2 during the Stroop task was positively correlated with sleep duration(P<0.05),while Poincaré plot SD2 during the 2-back task was positively correlated with mental fatigue assessment scores and was negatively correlated with sleep duration(both P<0.05).Conclusion The accuracy of the Stroop task and audiovisual competition task is a cognitive ability indicator sensitive to mental fatigue,while the Poincaré plot SD2 during Stroop and 2-back tasks is an ECG indicator sensitive to mental fatigue.
8.Association of digit ratio with polymorphisms at three loci of matrix metalloproteinase 9 gene in Ningxia Han youths
Meng-Yi YANG ; Jin ZHANG ; Shi-Bo NIU ; Jie DANG ; Zhan-Bing MA ; Hong LU ; Zheng-Hao HUO ; Yu XU ; Dan SHEN
Acta Anatomica Sinica 2025;56(1):74-79
Objective To investigate the association of digit ratio with single nucleotide polymorphism(SNP)at three loci(rs17576,rs3918249,rs9509)of matrix metallopeptidase 9(MMP-9)gene.Methods A total of 804 Ningxia Han youths(399 males and 405 females)were used as the study subjects.A digital camera was used to take frontal photographs of the hands,and image analysis software was used to mark the anatomical points and measure the lengths of each finger of both hands(2D,3D,4D,5D);Multiplexed PCR was used to detect the three polymorphic sites of the MMP-9 gene,SPSS 25.0 and R Studio software were used for data analysis and plotting.Results The 2D/3D(P<0.05)and 2D/4D(left,P<0.01,right,P<0.05)of both hands,2D/5D(P<0.01),3D/5D,4D/5D(P<0.05)of the right hand,and 3D/4D(P<0.05)of the left hand in female youths of Ningxia Han were significantly higher than those in males,Differences in genotypes and allele frequencies at all 3 loci of the MMP-9 gene were not statistically significant between genders(P>0.05).Right hand 2D/4D was significantly associated with genotypes at the rs17576 and rs3918249 loci in male youths(P<0.05).Conclusion MMP-9 gene SNPs(rs17576 and rs3918249)may be associated with the formation of 2D/4D of Ningxia Han male youths.
9.Effects of high-fat diet intake on pharmacokinetics of rabeprazole sodium enteric-coated tablets in healthy Chinese subjects
Cai-hui GUO ; Yu-fang XU ; Cong-yang DING ; Guang-tao HAO ; Hao-jing SONG ; Xue SUN ; Zhan-jun DONG ; Wan-jun BAI
The Chinese Journal of Clinical Pharmacology 2025;41(2):225-229
Objective To evaluate the effects of fasting and high-fat diet on the pharmacokinetics of rabeprazole sodium enteric-coated tablets in healthy Chinese subjects.Methods A single-center,randomized,open,two-agent,two-sequence,four-cycle,fully repeated crossover,single-dose trial design was used in this study,healthy subjects were assigned to receive single dose of rabeprazole sodium enteric-coated tablets 0.1 g in either fasting or high-fat diet state,and blood samples were taken at different time points,respectively.The concentrations of rabeprazole sodium enteric-coated in plasma were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS),the model method of the non-compartmental was used to calculate the pharmacokinetic parameters by Phoenix WinNonlin 8.2.Results The main pharmacokinetic parameters of rabeprazole sodium enteric-coated tablets in fasting state and high-fat diet state were as follows:Cmax were(339.63±156.47)and(318.86±132.13)ng·mL-1;t1/2 were(2.34±0.68)and(3.60±2.40)h;AUC0_t were(556.62±251.65)and(528.50±201.78)ng·mL-1·h;AUC0-∞ were(563.39±255.69)and(535.15±203.24)ng·mL-1·h;tmax were 3.65 and 6.99 h.After high-fat diet,the Cmax and AUC of rapeprazole sodium after high-fat and high-calorie diet decreased,Cmax decreased by 6.12%,AUC0-t decreased by 5.05%,AUC0-∞ decreased by 5.01%,andtmaxwas delayed by about 3.34 h.Cmax,AUC0-t and AUC0-∞ 90%confidence interval were 73.13%-115.10%,83.22%-112.28%and 83.40%-112.13%,respectively.Neither was between 85.00%-125.00%.Conclusion High-fat diet affects the absorption rate and degree of rabeprazole sodium enteric-coated,so it is suitable to be administered on an empty stomach.
10.Association between estimated cumulative LDL-C exposure and coronary artery disease severity and 2-year prognosis in acute coronary syndrome patients
Yichun HAO ; Jing CHEN ; Shaodi YAN ; Ying SONG ; Lin JIANG ; Yan CHEN ; Cheng CUI ; Zhan GAO ; Xueyan ZHAO ; Yin ZHANG ; Lijian GAO ; Jue CHEN ; Jinqing YUAN ; Lei SONG ; Jingjing XU
Chinese Journal of Cardiology 2025;53(3):274-280
Objective:To investigate the association between estimated cumulative low-density lipoprotein cholesterol (LDL-C) exposure and the severity of coronary artery disease and long-term adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute coronary syndrome (ACS).Methods:The subjects were from the PROMISE study. This study was a prospective cohort study led by Fuwai Hospital, Chinese Academy of Medical Sciences, with participation from eight regional tertiary hospitals as sub-centers, and enrolled 18 701 patients with confirmed coronary heart disease between January 2015 and May 2019. Among them, 8 429 patients with ACS were included in this study. The estimated cumulative LDL-C exposure was calculated by multiplying LDL-C by age. Participants were then divided into four groups based on quartiles. Baseline data and coronary angiography data were collected, and participants were followed for 2 years. The primary endpoint was MACCE, which was composed of all-cause death, cardiac death, myocardial infarction, revascularization, and stroke. Spearman correlation analysis was used to estimate the correlation between cumulative LDL-C exposure and the severity of coronary artery disease. The differences in MACCE among the four groups were compared, and multivariate Cox regression was used to divide the estimated cumulative exposure LDL-C into two groups, three groups, and four groups to analyze its relationship with MACCE.Results:The 8 429 ACS patients included in the study had an age of (60.9±11.4) years, with 1 951(23.1%) females. Spearman correlation analysis revealed that estimated cumulative LDL-C exposure was positively associated with the preoperative SYNTAX score, three-vessel lesions disease, left main disease, and the number of target lesions (correlation coefficients r=0.14, 0.10, 0.04 and 0.03, respectively, with all P<0.05). The 2-year follow-up results indicated that the incidence rates of MACCE, all-cause death, cardiac death, myocardial infarction, and stroke in ACS patients grouped by different levels of estimated cumulative LDL-C exposure were statistically significant (all P<0.05). The results of the Cox multivariate regression analysis showed that when the estimated cumulative LDL-C exposure was treated as a continuous variable and analyzed in two, three, and four groups, with the lowest group as the reference, the risk of MACCE occurrence in the high-value group increased by 21% (95% CI 1.08-1.37, P=0.002), 24% (95% CI 1.07-1.43, P=0.004), and 21% (95% CI 1.02-1.43, P=0.025) respectively. Conclusions:A positive correlation was found between estimated cumulative LDL-C exposure and severity of coronary artery disease. High estimated cumulative LDL-C exposure level is a risk factor for MACCE in ACS patients within 2 years.

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