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.Influenza surveillance results in Ordos City in 2017 - 2023
Xiaomin ZHANG ; Hongtao XIAO ; Sheng WANG ; Rong SUN ; Shangwu JIN ; Di ZHANG ; Jiming HAO ; Jialin LYU ; Chunyan YANG
Journal of Public Health and Preventive Medicine 2026;37(2):54-58
Objective To analyze the influenza-like illness (ILI) data in Ordos City from 2017 to 2023 and conduct nucleic acid detection of the virus to understand the local influenza epidemic situation, and to provide a reliable basis for influenza prevention and control in the city. Methods Real-time quantitative polymerase chain reaction (qPCR) was used to identify virus subtypes in ILI throat swab samples. Comparisons of positive rates were conducted using the chi-square test, with a significance level of α=0.05. Results From 2017 to 2023, a total of 3,283,434 outpatient and emergency visits were recorded at the Ordos City Central Hospital, including 74,159 ILI cases, with an ILI proportion of 2.26%. The majority of ILI cases (74.43%) occurred in children aged 0~14 years old. The overall positive rate of influenza virus nucleic acid detection was 10.87%, with the highest proportion being subtype A (seasonal H3) at 43.03%. The highest detection rate was observed in the 5~14 years age group, with statistically significant differences in positive rates across age groups (χ2=155.638, P<0.001). Influenza peaks occurred mainly from November to March of the following year. From January to April, three types of influenza were prevalent alternately or mixed, while from October to December, subtype A (seasonal H3) predominated. Positive rates varied significantly across months (χ2=250.923, P<0.001). The temporal trends of ILI proportions and PCR-positive rates were consistent. Conclusion Influenza in Ordos City exhibits distinct seasonal and age distribution characteristics, with alternating or mixed circulation of three virus types. Continued efforts are needed to strengthen influenza surveillance, especially the prevention and control of influenza in infants and adolescents.
4.Assessment of health exposure risks from preservatives in beverages sold near primary schools in Anshun
XU Lin, QU Guangsheng, DAI Qian, LU Shunhua, CAI Guixiang, ZHANG Jialin, WEI Gang
Chinese Journal of School Health 2026;47(1):129-133
Objective:
To quantitatively assess the health risk of preservatives from beverages around primary schools in Anshun City, and to provide scientific basis for precise food safety supervision.
Methods:
From December 2023 to July 2024, 602 beverage samples were randomly collected from within 100 meters of 19 primary schools in Anshun City. The content of benzoic acid, sorbic acid, and dehydroacetic acid was detected according to GB 5009 series standards. Combined with children s physiological parameters (body weight 30 kg, daily intake 0.15 L), the Hazard Quotient (HQ) and Hazard Index (HI) models were used to evaluate health risks.
Results:
The total detection rate of preservatives from beverages around primary schools was 63.0%, and the total over limit rate was 9.0%. The detection rate of preservatives in flavored beverages was the highest (72.6%), and the highest over limit rate of preservatives in special purpose beverages was the highest (17.2%). The single preservative HQ (benzoic acid up to 0.47 ) and mixed HI (up to 0.55) of all samples were below 1(safety threshold). However, the HQ value of benzoic acid in flavored beverages (0.47) was 2.9 times that of sorbic acid (0.16), contributing significantly to health risk. Sensitivity analysis showed that if the daily consumption increased to 0.3 L, the HI value of flavored beverages would rise to 1.11, exceeding the safety threshold. Enterprise scale analysis showed that the exceedance rate of special purpose beverages in large enterprises reached 30.0%, while micro enterprises, accounting for a dominant market share (52.2%), constituted the main source of children s daily exposure to their products.
Conclusions
The overall health risk of perservatives in beverages sold near primary schools in Anshun City is controllable, but there is a noticeable risk of gradient. The risk of children’s exposure to preservatives through beverage consumption should not be ignored.
5.Qualitative research and path exploration of postgraduate education in humanistic medicine
Jialin ZHANG ; Mengle WANG ; Mingkai ZHAO ; Baojun LUO
Chinese Medical Ethics 2026;39(10):1402-1409
Adopting a qualitative research method, this paper conducted semi-structured interviews with 17 postgraduate students in humanistic medicine from 8 recruiting universities, systematically analyzing the current status and development dilemmas of postgraduate education in humanistic medicine. It was found that postgraduate education in humanistic medicine faced multidimensional challenges. At the disciplinary cognition level, there were issues such as inconsistent subject affiliation, passive and differentiated student cognition, and limited social cognition. In terms of disciplinary resources, it exhibited characteristics such as insufficient practical resources, weak faculty resources, and limited journal resources. Regarding the curriculum system, it exposed structural contradictions such as a low relevance of course content, a disconnection between theory and practice, and the fragmentation of course structure. As for training mechanisms, it confronted systemic bottlenecks such as complex student source structures, constrained training tiers, and significant disciplinary employment barriers. Based on the issues identified in disciplinary construction, this paper proposed optimization paths, including measures such as strengthening the disciplinary cognition system, enhancing disciplinary resource establishment, optimizing the curriculum system, and improving the training mechanism. These aimed to provide theoretical support and practical references for the optimization and enhancement of postgraduate education in humanistic medicine in China, promote the high-quality development and improvement of humanistic medicine education cause, and contribute to the construction of a composite medical talent training system under the Healthy China strategy.
6.Ethical boundaries and one-dimensional care: a discussion on the subjectivity issue in Schweitzer’s reverence for life
Jialin YAN ; Xue ZHOU ; Mengmeng ZHANG
Chinese Medical Ethics 2026;39(10):1418-1424
Albert Schweitzer’s ethical thought of “reverence for life” breaks the limitation of traditional ethics that only focuses on human beings. It extends the scope of care to all living beings and provides important ideas for resolving problems concerning the relationship between humans and nature. However, this thought lacks a clear definition of “who is the ethical subject,” which leads to divergent interpretations and applications within academic circles. In fact, the core of this ethical framework lies in “asymmetric intersubjectivity.” That is, humans possess unique capacities for moral reflection, moral action, and moral responsiveness, making them the only complete ethical subjects and bearing the obligation to actively care for non-human lives. Meanwhile, non-human lives carry intrinsic life value and merit respect, yet they cannot bear moral responsibilities and merely serve as ethical objects receiving care. After sorting out this core logic, the concept of “moral agent” was introduced to provide an analytic method with both theoretical rigor and practical operability for real-world issues such as ethical decision-making in medicine and the application of life technologies.
7.Adjuvant therapy after compromised sublobar resection for pathological stage ⅠA peripheral solid-type non-small cell lung cancer in patients with advanced age or poor cardiopulmonary function
Yu LU ; Jialin ZHANG ; Haoyan NIU ; Honggang KE ; Xiaodan WENG ; Jiaping ZHAO ; Hao ZHOU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(10):1609-1616
Objective To explore the adjuvant treatment options for elderly patients or those with low cardiopulmonary function who cannot tolerate lobectomy for peripheral solid pathological stage ⅠA (pⅠA) non-small cell lung cancer (NSCLC). Methods A retrospective analysis was conducted on the clinical data of patients with peripheral solid pⅠA stage NSCLC treated with lobectomy and compromised sublobar resection (CSR) in the Affiliated Hospital of Nantong University, from 2018 to 2019. The incidence of postoperative complications and independent predictors of postoperative recurrence were analyzed. Patients in the CSR group were divided into a targeted therapy group, a chemotherapy group, and an observation group based on postoperative treatment measures. The 3-year recurrence-free survival (RFS) rate and 5-year overall survival (OS) rate of the three subgroups before and after propensity score matching (PSM) were compared. Results A total of 586 patients were included, including 288 (49.15%) males and 298 (50.85%) females, with a median age of 64.00 years. There were 335 patients of lobectomy and 251 patients of CSR. There was no statistically significant difference in the incidence of postoperative complications between the lobectomy group and CSR group [RR=0.987, 95%CI (0.898, 1.085), P=0.789]. Multivariate analysis showed that gender, tumor location, and size were independent risk factors for recurrence after CSR. After PSM, 17 patients were enrolled in each of the three subgroups of CSR. Kaplan-Meier survival curve analysis showed that there was no statistically significant difference in the 3-year RFS rate (P=0.115) and 5-year OS rate (P=0.101) between the targeted therapy group and chemotherapy group after PSM. The 3-year RFS rate and 5-year OS of the targeted group were significantly better than those of the observation group (P=0.041, P=0.009). Compared with lobectomy, there was no statistically significant difference in the 3-year RFS rate (P=0.069) and 5-year OS rate (P=0.540) in the targeted therapy group, while the chemotherapy group and observation group were significantly inferior to the lobectomy group (P<0.05). Conclusion CSR for treating stage pⅠA peripheral solid NSCLC in patients with advanced age or poor cardiopulmonary function does not increase the incidence of postoperative complications. Gender, tumor location, and size are independent risk factors for postoperative recurrence. In terms of 3-year RFS rate and 5-year OS rate, adjuvant targeted therapy after CSR is not only superior to observation but also not inferior to lobectomy.
8.Traditional Chinese Medicine Regulates Signaling Pathways Related to Precancerous Lesions of Gastric Cancer: A Review
Maofu ZHANG ; Xinyu LI ; Yanyun SHEN ; Yeyuan LIU ; Jialin ZHONG ; Lulu CHEN ; Haihong ZHAO ; Zhongyang SONG ; Zhiming ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):297-306
Precancerous lesions of gastric cancer (PLGC) are a group of pathological changes caused by abnormalities in the structure, morphology, and differentiation of gastric mucosal epithelial cells. Since the early symptoms are hidden and non-specific, PLGC is not easy to be diagnosed and it has often developed into intermediate or advanced gastric cancer once being diagnosed and missed the best time for treatment. Accordingly, the incidence of this disease is increasing year by year, which lifts a heavy burden on the patients. The pathogenesis of PLGC is complex, involving inflammatory microenvironment, bile reflux, glycolysis, autophagy, and apoptosis. Currently, PLGC is mainly treated with anti-inflammatory and endoscopic therapies, which are difficult to curb the development of PLGC. Therefore, seeking a safe and effective therapy is an important topic of modern research. Traditional Chinese medicine (TCM), characterized by treatment based on syndrome differentiation and a holistic view, exerts effects via multiple pathways, mechanisms, and targets. Recent studies have confirmed that TCM can regulate the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR), Wnt/β-catenin, Sonic Hedgehog, nuclear factor-κB (NF-κB), Janus kinase/signal transducer and activator of transcription (JAK/STAT), hypoxia-inducible factor-1α (HIF-1α), neurogenic locus notch homolog protein (Notch), nuclear factor E2-related factor 2 (Nrf2) and other signaling pathways. By targeting these pathways, TCM can inhibit aerobic glycolysis, reduce oxidative stress, repair the inflammatory microenvironment, regulate cellular autophagy, and promote vascular normalization, thereby delaying or reversing PLGC. However, few researchers have systematically summarized the TCM regulation of PLGC-associated pathways. By reviewing the relevant articles at home and abroad, this paper summarized the roles of the above signaling pathways in the development of PLGC and the research progress in the regulation of signaling pathways by TCM in the treatment of PLGC, with a view to providing a new theoretical basis for the clinical research on PLGC and the drug development for this disease.
9.Research progress on pathogenesis as well as prevention and treatment of chronic rhinosinusitis with traditional chinese medicine
Wenyi WANG ; Jingyi ZHANG ; Jialin SONG ; Chuanchuan PAN ; Yuetong ZHOU
Journal of Clinical Medicine in Practice 2025;29(10):140-145
Chronic rhinosinusitis(CRS)is a common chronic inflammation of nasal cavity and sinus mucosa,involving multiple pathogenesis mechanisms such as infection,allergic reactions,and immune abnormalities.Its main symptoms include nasal obstruction,rhinorrhea,and hyposmia,sig-nificantly affecting patients' quality of life.Seeking safe and effective long-term treatment methods is crucial for managing CRS.Traditional Chinese medicine(TCM)has a long history of treating CRS and has gained attention due to its profound theoretical basis,high safety,and low recurrence rate.According to TCM,CRS is mostly caused by the invasion of wind-cold-damp pathogens,heat accumu-lation in the Lung meridian,or spleen-stomach weakness.Various therapies such as oral administra-tion of Chinese herbal medicines,nasal drops,acupuncture,and moxibustion are employed to adjust the body's balance and achieve therapeutic goals.This article comprehensively analyzed recent do-mestic and international literature and reviewed the research progress on pathogenesis of CRS and its treatment with TCM,with particular emphasis on roles and mechanisms of active ingredients in Chi-nese herbal medicines.The aim of the study is to provide scientific evidence and technical support for prevention and treatment of CRS.
10.A qualitative study on economic toxicity perceptions and experiences of caregivers of colorectal cancer patients from the perspective of social ecological systems theory
Yang XU ; Yu ZHANG ; Xujun YUAN ; Jialin CHEN ; Zhilian HE ; Ranran MIAO ; Ping YU
Journal of Clinical Medicine in Practice 2025;29(17):104-109
Objective To explore the economic toxicity perceptions and experiences of caregivers of colorectal cancer patients from the perspective of social ecological systems theory.Methods Using purposive sampling,18 caregivers of colorectal cancer patients hospitalized in the gastrointestinal sur-gery and oncology departments of a tertiary grade A hospital in Yangzhou were selected for semi-struc-tured interviews.The Colaizzi 7-step analysis method was employed to organize and analyze the data.Results Three main themes and nine sub-themes were extracted regarding the economic toxicity expe-riences and needs of caregivers of colorectal cancer patients.Microsystem included multiple negative experiences,impacted individual health,and difficulties in surrogate decision-making;mesosystem in-cluded heavy family financial burden,altered family lifestyle,and tense family atmosphere;macrosys-tem included needs for the scope and intensity of medical insurance reimbursement,needs for medical resources and services,and a desire for social support.Conclusion The ecological system of caregiv-ers of colorectal cancer patients is not optimistic,and is generally affected by economic toxicity.Inter-vention strategies can be sought from multiple aspects,including alleviating the negative experiences of caregivers,strengthening social support,and paying attention to the needs of caregivers,aiming to re-duce the level of economic toxicity among caregivers of colorectal cancer patients.


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