1.LI Guolie's Experience in Treating Orthostatic Hypotension from the Perspective of "Raising the Clear and Directing the Turbid Downward"
Zhihui JIN ; Yanjie JIANG ; Wenshan LI ; Xiaoyu ZHU ; Yan LU ;
Journal of Traditional Chinese Medicine 2026;67(9):941-945
This paper summarizes professor LI Guolie's clinical experience in treating orthostatic hypotension (OH) based on the theory of "raising the clear and directing the turbid downward". It is considered that the core pathogenesis of OH lies in the body's transition from a supine to an upright position, during which dysfunction of the middle jiao (焦) transformation and transportation, along with impaired pivot function, hinders the ascending of clear yang and the descending of turbid yin. Treatment should follow the general principle of "ascending the clear and directing the turbid downward", placing emphasis on distinguishing the primary and secondary aspects. For cases where the clear yang fails to ascend, the self-formulated Li's Shengqing Jiangzhuo Decoction (李氏升清降浊汤)is used to supplement qi, raise the clear, and strengthen the middle jiao. For cases where the turbid yin fails to descend, the self-formulated Wuxiang Qingzhuo Beverage(五香清浊饮)with modifications is applied to resolve phlegm, eliminate stasis, harmonize the middle, and descend the turbid.
2.A comprehensive review of risk factors for pulmonary infection after kidney transplantation
Jiayuan CHEN ; Mingxi KUANG ; Youqing YAN ; Jingting WANG ; Zhen LI
Organ Transplantation 2026;17(3):503-511
Objective To conduct a comprehensive review of the risk factors for post-transplant pulmonary infection in kidney transplant recipients. Methods Following the methodology guidelines for systematic reviews, the research question was clearly defined. Systematic searches were conducted in both Chinese and English literature databases, with the search period ranging from the establishment of the database to May 1, 2025. Two researchers independently screened and extracted the risk factors related to post-transplant pulmonary infection in kidney transplant recipients, and the research results were qualitatively described. Results A total of 45 articles were finally included, involving 30 risk factors for post-transplant pulmonary infection in kidney transplant recipients, including five aspects as donor factors, recipient factors, disease factors, treatment factors and laboratory test result factors. Conclusions The occurrence of post-transplant pulmonary infection in kidney transplant recipients is related to donor factors, recipient factors, disease factors, treatment factors and laboratory test result factors, providing a reference for clinical prevention, screening, and intervention.
3.LI Guolie's Experience in Treating Orthostatic Hypotension from the Perspective of "Raising the Clear and Directing the Turbid Downward"
Zhihui JIN ; Yanjie JIANG ; Wenshan LI ; Xiaoyu ZHU ; Yan LU ;
Journal of Traditional Chinese Medicine 2026;67(9):941-945
This paper summarizes professor LI Guolie's clinical experience in treating orthostatic hypotension (OH) based on the theory of "raising the clear and directing the turbid downward". It is considered that the core pathogenesis of OH lies in the body's transition from a supine to an upright position, during which dysfunction of the middle jiao (焦) transformation and transportation, along with impaired pivot function, hinders the ascending of clear yang and the descending of turbid yin. Treatment should follow the general principle of "ascending the clear and directing the turbid downward", placing emphasis on distinguishing the primary and secondary aspects. For cases where the clear yang fails to ascend, the self-formulated Li's Shengqing Jiangzhuo Decoction (李氏升清降浊汤)is used to supplement qi, raise the clear, and strengthen the middle jiao. For cases where the turbid yin fails to descend, the self-formulated Wuxiang Qingzhuo Beverage(五香清浊饮)with modifications is applied to resolve phlegm, eliminate stasis, harmonize the middle, and descend the turbid.
4.Effectiveness of generative large language model MedGo in nursing decision-making for elderly patients with multimorbidity
Qiaoyun YAN ; Min LI ; Yawen YAN ; Yaqing NI ; Yun GU ; Jiawen QIN ; Haiping YU ; Haitao ZHANG ; Liming ZHAO
Chinese Journal of Clinical Medicine 2026;33(1):16-23
Objective To explore the effectiveness of the generative large language model MedGo in nursing decision-making for elderly patients with multimorbidity. Methods A quasi-randomized controlled trial study was conducted involving 6 junior nurses, 6 senior nurses and the MedGo model from January 1, 2025 to March 31, 2025 at the Emergency Internal Medicine Ward of Shanghai East Hospital Affiliated to Tongji University. Clinical data of 120 elderly patients with multimorbidity were analyzed to compare the performance of the three groups in four tasks (nursing diagnosis assessment, nursing intervention formulation, complication identification, and complication prevention) from three evaluation dimensions: decision-making time consumption, decision accuracy, and decision-making quality. Results In terms of decision-making time, the senior nurse group completed all four tasks faster than the junior nurse group (P<0.01), and the MedGo group completed all four tasks faster than the junior nurse group (P<0.001) and the senior nurse group (P<0.001). In terms of decision-making accuracy, senior nurse group scored higher than junior nurse group in all four tasks (P<0.001), while the MedGo group outperformed the senior nurse group only in complication identification (P<0.001). In terms of decision-making quality, the MedGo group scored higher than junior nurse group (P<0.001) and senior nurse group (P<0.001) in all four tasks. Conclusions The MedGo model demonstrates advantages of high efficiency, accuracy, and quality in nursing decision-making for elderly patients with multimorbidity; senior nurses outperform junior nurses in decision-making, providing diverse references for clinical nursing decision-making.
5.Clinical efficacy of Huangkui capsules in the treatment of targeted drug-related proteinuria in patients with hepatocellular carcinoma
Miao LI ; Jia YUAN ; Chu LIU ; Maopei CHEN ; Xin XU ; Ningling GE ; Yi CHEN ; Lan ZHANG ; Rongxin CHEN ; Yan WANG
Chinese Journal of Clinical Medicine 2026;33(1):88-94
Objective To investigate the therapeutic effect of Huangkui capsules on targeted drug-related proteinuria in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on clinical data of HCC patients with targeted drug-related proteinuria from June 2023 to December 2024 at Zhongshan Hospital, Fudan University. According to the treatment plan, patients were divided into the conventional treatment group and the Huangkui combination treatment group (Huangkui capsules combined with conventional treatment), and the clinical efficacy between the two groups was compared. The logistic regression analysis was used to identify the main factors affecting treatment efficacy. Results The Huangkui combination treatment group (n=29) showed a significantly higher overall effective rate (79.3% vs 42.3%, P=0.005), and an earlier proteinuria improvement (median time: 3 months vs 6 months, P=0.008) than the conventional treatment group (n=26) . The multivariate logistic regression analysis showed angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker (ARB) using (OR=0.190, 95%CI 0.045-0.808, P=0.025), targeted drug adjustment (OR=0.132, 95%CI 0.030-0.581, P=0.007), and Huangkui capsules using (OR=0.168, 95%CI 0.039-0.730, P=0.017) were protective factors for treatment efficacy of targeted drug-related proteinuria. Conclusions On the basis of conventional treatment, additive treatment with Huangkui capsules can alleviate targeted drug-related proteinuria faster and more effectively in HCC patients.
6.Expert Consensus on Clinical Application of Qidong Yixin Oral Liquid
Changkuan FU ; Xiaochang MA ; Mingjun ZHU ; Yue DENG ; Hongxu LIU ; Mingxue ZHANG ; Ying CHEN ; Yan ZHOU ; Ling ZHANG ; Jianhua FU ; Wei YANG ; Yu'er HU ; Ming CHEN ; Yanming XIE ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):147-158
The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis (VMC). It has the functions of tonifying Qi, nourishing the heart,calming the mind, and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However,the understanding of its efficacy evidence, advantageous aspects, dosage and administration, and medication safety remains insufficient in clinical practice. Therefore,the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid (hereinafter referred to as consensus) was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine,successively completing multiple tasks such as the consensus project initiation,determination of clinical problems,evidence search and evaluation,formation of recommendation opinions and consensus suggestions,solicitation of opinions,peer review, submission for review and release, and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions,clarifying the clinical positioning,efficacy advantages,syndrome differentiation,dosage and administration,combination therapy,timing of medication,adverse reactions,contraindications, and precautions of Qidong Yixin oral liquid,indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease,providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23, 2024. Standard number:GSCACM-376-2024.
7.Active Ingredients of Traditional Chinese Medicine Regulate Ferroptosis to Inhibit Breast Cancer: A Review
Yan LIU ; Zhenyao YANG ; Chengzhi WANG ; Jiuxian LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):299-306
Breast cancer (BC), a common malignant tumor in women, is characterized by high incidence and mortality rates, posing a serious threat to women's life and health. Currently, the commonly used treatments for BC include surgery, radiotherapy, chemotherapy, molecular targeted therapy, and endocrine therapy. Although radiotherapy and chemotherapy can effectively kill tumor cells and inhibit the proliferation and differentiation of tumor cells, they can induce adverse reactions such as hematopoietic dysfunction and impaired immune function. The other treatment methods also have problems such as drug resistance, high recurrence rates, reduced quality of life, and poor clinical efficacy. Therefore, it is urgent to explore new drugs with better efficacy and lower toxicity. Ferroptosis is a form of iron-dependent, non-apoptotic programmed cell death triggered by lipid peroxidation. In recent years, ferroptosis has become a hot topic in the field of cancer treatment and has been gradually proven to effectively inhibit the proliferation and metastasis of BC cells, reduce the drug resistance of BC to chemotherapy drugs, and enhance the sensitivity of BC to radiotherapy. Traditional Chinese medicine (TCM), with multiple components, multiple targets, and mild side effects, is widely used in the treatment of BC. A large number of studies have shown that active ingredients of TCM, such as saponins, flavonoids, terpenoids, phenols, and polysaccharides, can inhibit the proliferation and metastasis of BC cells by modulating ferroptosis-related pathways. These include iron metabolism, lipid metabolism, cystine/glutamate antiporter system Xc-/glutathione/glutathione peroxidase 4, Specifically, these ingredients elevate the levels of lipid peroxidation, reactive oxygen species, malondialdehyde, and Fe2+ in BC cells, thereby inducing ferroptosis-mediated suppression of tumor progression. This article reviews the relevant literature at home and abroad in recent years, summarizes the mechanisms of ferroptosis in regulating BC and the research progress in the active components of TCM targeting ferroptosis in the intervention of BC, aiming to provide ideas for the development of new drugs for the treatment of BC.
8.Altered Lymphocyte Subsets in Perioperative Cancer Patients Before and After Septic Shock: Characteristics and Prognostic Implications
Miao WEI ; Lili YANG ; Xiaoyan LI ; Huifang LYU ; Yan DUAN
Medical Journal of Peking Union Medical College Hospital 2026;17(1):86-97
To investigate the changes in peripheral blood immune cells before and after the onset of septic shock in patients with malignant tumors, and to analyze the relationship between these immune cells and patient prognosis. A retrospective study was conducted, enrolling perioperative tumor patients who were transferred to the intensive care unit (ICU) due to septic shock at Shanxi Provincial Cancer Hospital between October 2018 and December 2019.Changes in lymphocyte counts and subsets were compared before and after septic shock (measured prior to septic shock onset and within 72 hours after onset).A multivariate Logistic regression model was used to analyze the relationship between these immune indicators and the 28-day mortality risk in tumor patients following septic shock. A total of 47 tumor patients transferred to the ICU due to septic shock were included.There were 32 males and 15 females, with a mean age of (63.9±11.2) years.Gastrointestinal tumors were the most common tumor type (76.60%, 36/47), and abdominal/pelvic infection (65.96%, 31/47) was the primary source of infection.Within 28 days after ICU transfer, 12 patients died and 35 survived. Compared to pre-septic shock levels, lymphocyte counts significantly decreased after septic shock[530(300, 830) cells/μL Perioperative tumor patients experience acute depletion of peripheral blood lymphocyte subsets following septic shock.Among various immune indicators, regulatory T cell count serves as an independent predictor of short-term mortality risk.Evaluating baseline immune function in such patients may help optimize treatment strategies and improve overall prognosis.
9.Explainable Machine Learning Model for Predicting Prognosis in Patients with Malignant Tumors Complicated by Acute Respiratory Failure: Based on the eICU Collaborative Research Database in the United States
Zihan NAN ; Linan HAN ; Suwei LI ; Ziyi ZHU ; Qinqin ZHU ; Yan DUAN ; Xiaoting WANG ; Lixia LIU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):98-108
To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework. Clinical data of patients with malignant tumors and ARF were extracted from the eICU Collaborative Research Database in the United States, including demographic characteristics, comorbidities, vital signs, laboratory test indicators, and major interventions within the first 24 hours after ICU admission.The study outcome was ICU death.Enrolled patients were randomly divided into a training set and a validation set at a ratio of 7:3.Predictor variables were selected using least absolute shrinkage and selection operator (LASSO) regression.Five machine learning algorithms-extreme gradient boosting (XGBoost), support vector machine (SVM), Logistic regression, multilayer perceptron (MLP), and C5.0 Decision Tree-were employed to construct predictive models.Model performance was evaluated based on the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and other metrics.The optimal model was further interpreted using the Shapley additive explanations (SHAP) algorithm. A total of 3196 patients with malignant tumors complicated by ARF were included.The training set comprised 2, 261 patients and the validation set 935 patients; 683 patients died during ICU stay, while 2513 survived.LASSO regression ultimately selected 12 variables closely associated with patient ICU outcomes, including sepsis comorbidity, use of vasoactive drugs, and within the first 24 hours after ICU admission: minimum mean arterial pressure, maximum heart rate, maximum respiratory rate, minimum oxygen saturation, minimum serum bicarbonate, minimum blood urea nitrogen, maximum white blood cell count, maximum mean corpuscular volume, maximum serum potassium, and maximum blood glucose.After model evaluation, the XGBoost model demonstrated the best performance.The AUCs for predicting ICU mortality risk in the training and validation sets were 0.940 and 0.763, respectively; accuracy was 88.3% and 81.2%;sensitivity was 98.5% and 95.9%.Its predictive performance also remained optimal in sensitivity analyses.SHAP analysis indicated that the top five variables contributing to the model's predictions were minimum oxygen saturation, minimum serum bicarbonate, minimum mean arterial pressure, use of vasoactive drugs, and maximum white blood cell count. This study successfully developed a mortality risk prediction model for ICU patients with malignant tumors complicated by ARF based on a large-scale dataset and performed explainability analysis.The model aids clinicians in early identification of high-risk patients and implementing individualized interventions.
10.DING Ying's Clinical Experience in Treating Systemic Lupus Erythematosus Based on Differentiation of Yin Fire,Latent Fire,and Fire Toxin
Hongji WU ; Min GAO ; Yan XU ; Xuejun LI ; Jiexin SU ;
Journal of Traditional Chinese Medicine 2026;67(4):365-369
This paper summarizes Professor DING Ying's clinical experience in the treatment of systemic lupus erythematosus (SLE) through differentiation of three states, yin fire, latent fire, and fire toxin. It is proposed that fire pathogenic factors constitute a key pathological element running throughout the entire disease course of SLE. The evolution of its pathogenesis centers on these three states, spleen-kidney deficiency with the initial emergence of yin fire as the onset of disease, damage to yin by medicinal toxicity with internal blazing of latent fire as the driver of disease progression, and the interlocking of blood stasis and heat with intense scorching by fire toxin as the critical factor leading to severe and life-threatening conditions. Corresponding to these three stages, targeted prescriptions are formulated, Jiuwei Yishen Formulation (九味益肾方) to tonify the spleen and kidney, raise yang, and disperse fire; Ziyin Xiehuo Decoction (滋阴泄火汤) to nourish yin and fluids while clearing latent fire; and Santeng Changluo Jiedu Decoction (三藤畅络解毒汤) to dispel blood stasis, unblock the collaterals, detoxify, and restrain fire. This staged and integrated therapeutic strategy aims to address both root and branch and to achieve overall regulation, providing valuable guidance for the clinical differentiation and treatment of SLE.

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