1.Pathogenesis Evolution and Prevention-treatment Strategies for Hypertension-related Coronary Microvascular Dysfunction Based on Collateral Disease Theory
Mingyan HUANG ; Linzi LONG ; Xin LIU ; Chao LIU ; Lifang SONG ; Changgeng FU ; Jiahui QIN ; Jieming LU ; Yi LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):239-248
This article explores the pathogenesis , evolution and the prevention-treatment strategies of hypertension-related coronary microvascular dysfunction (H-CMD) from the collateral disease theory. Long-term hypertension may lead to coronary microvascular vasomotor imbalance, endothelial injury, vascular remodeling, microthrombosis, reduced perfusion reserve, and microvascular rarefaction, suggesting a progressive pathological process from functional disturbance to structural injury, collateral obstruction, and insufficient repair. Collateral disease theory emphasizes the network-like distribution, gradual branching, and permeating and nourishing functions of collaterals, as well as the concept that prolonged disease enters the collaterals, providing a reference for understanding coronary microcirculatory dysfunction and malnourishment of heart collaterals. Accordingly, the traditional Chinese medicine (TCM) pathogenesis of H-CMD can be summarized into four interconnected stages: Collateral Qi stagnation, scorching injury of collateral vessels, phlegm-stasis obstruction of collaterals, and collateral deficiency with malnourishment. Collateral Qi stagnation is the initiating stage, mainly corresponding to abnormal coronary microvascular vasomotor regulation and endothelial dysfunction. Scorching injury of collateral vessels represents the developmental stage and is closely associated with inflammation, oxidative stress, and endothelial barrier injury after Qi stagnation transforms into fire. Phlegm-stasis obstruction of collaterals represents the prolonged stage and may aggravate vascular wall thickening, luminal stenosis, microthrombosis, and insufficient microcirculatory perfusion. Collateral deficiency with malnourishment is the late-stage outcome, reflecting deficiency of healthy Qi, collateral damage, Qi-blood malnourishment, and weakened repair capacity, mainly manifested as microvascular rarefaction, occlusion, and microcirculatory homeostatic imbalance. Therapeutically, stage-based syndrome differentiation and the combined strategy of dredging and nourishing collaterals should be emphasized. Specifically, promoting Qi movement, resolving stagnation, soothing the liver, and harmonizing collaterals should be adopted in the early stage. Clearing heat, pacifying the liver, calming and protecting collaterals should be adopted in the developmental stage. Resolving phlegm, activating blood, and dredging collaterals should be implemented in the prolonged stage. Supplementing Qi, nourishing blood, tonifying the kidney, regulating balance, strengthening healthy Qi, and nourishing collaterals should be carried out in the late stage. Related formulas and medicinals may act by regulating the nitric oxide/endothelin-1(NO/ET-1) balance, inhibiting inflammation and oxidative stress, improving microcirculatory perfusion, and promoting angiogenesis and endothelial repair. Collateral disease theory may provide a theoretical basis for understanding the dynamic pathogenesis of H-CMD and for stage-based TCM intervention.
2.Development status and ethical challenges of artificial intelligence in traditional Chinese medicine
Jiaqing DAI ; Yuxuan JIANG ; Jingnan HU ; Liu YANG ; Lifang GUO
Chinese Medical Ethics 2025;38(2):173-178
In the context of the rapid development of 5G technology, the development of artificial intelligence (AI) in traditional Chinese medicine (TCM) faces new opportunities and challenges. Focusing on how to uphold tradition while innovating in the development of AI in TCM, starting from the current development status of AI in Chinese medicine, including the integration of four diagnostic methods, syndrome differentiation and treatment, auxiliary diagnosis and treatment, research and development of Chinese herbal medicine, prevention and treatment of diseases, knowledge inheritance, and other aspects, this paper discussed the support of policies and technical advancements, as well as development opportunities such as increased demand for health. Regarding machine ethics, data ethics, regulatory review, and other aspects, it also proposed some suggestions that the training algorithm should be improved to assist medical work; data ownership should be clarified to ensure data security; and an AI ethics committee should be set up to improve the review system, aiming to maximize the advantages of smart healthcare and accelerate the modernization of TCM for the benefit of patients and the service of human health.
3.Impact of ferroptosis-related gene expression on cardiovascular outcomes in chronic renal failure
Xuelan LIN ; Kexin LIU ; Xiao GE ; Yiming YU ; Lifang CAO
International Journal of Laboratory Medicine 2025;46(19):2378-2384,2390
Objective To investigate the relationship between ferroptosis-related genes[heme oxygenase-1(HO-1),solute carrier family 7 member 11(SLC7A11),and long-chain acyl-coenzyme A synthetase 4(ACSL4)]expression and cardiovascular events in patients with chronic renal failure(CRF),aiming to pro-vide clinical insights for risk assessment of cardiovascular complications.Methods A total of 124 CRF pa-tients(CRF group)admitted to the hospital from January 2020 to January 2023 and 124 healthy people(con-trol group)who underwent physical examination in the hospital during the same period were selected as the research objects.The levels of ferroptosis-related gene HO-1,SLC7A11 and ACSL4 were detected and com-pared between the two groups.CRF patients were followed up for 12 months after discharge,and they were di-vided into concurrent group(n=56)and non-concurrent group(n=66)according to the occurrence of cardio-vascular events.Spearman correlation analysis was used to investigate the correlation between iron death relat-ed genes HO-1,SLC7A11,ACSL4 and cardiovascular events in CRF patients.Univariate and multivariate Lo-gistic regression analysis were used to investigate the influencing factors of cardiovascular events in CRF pa-tients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of iron death re-lated genes HO-1,SLC7A11,and ACSL4 for cardiovascular events in CRF patients.Results Serum HO-1 and SLC7A11 levels in CRF group were lower than those in control group(P<0.05),and the ACSL4 level was higher than that in control group(P<0.05).The serum HO-1 and SLC7A11 levels in concurrent group were lower than those in non-concurrent group(all P<0.05),and the serum ACSL4 level was higher than that in non-concurrent group(P<0.05).Ferroptosis-related genes HO-1 and SLC7A11 were negatively correlated with cardiovascular events(r=-0.708,—0.721,P<0.05),while ACSL4 was positively correlated with car-diovascular events(r=0.699,P<0.05).High serum ACSL4 expression and high cTnT level were risk fac-tors for cardiovascular events in CRF patients(P<0.05),and high hemoglobin level and high serum HO-1 and SLC7A11 expression were protective factors for cardiovascular events in CRF patients(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum HO-1,SLC7A11,ACSL4,hemo-globin and cTnT alone for predicting cardiovascular events in CRF patients were 0.787,0.735,0.773,0.651 and 0.782,respectively.The AUC of the combined prediction of ferroptosis-related genes was 0.837,and the AUC of the combined application of five factors was 0.880.According to Delong's test,the AUC of both com-bined application models was significantly higher than those of individual application(P<0.05).The nomo-gram model showed that all ferroptosis-related genes were positively expressed(HO-1<1.5,SLC7A11<1.15,ACSL4≥2.75),and the risk of developing concurrent cardiovascular events in CRF patients could reach over 75%.Conclusion The expression of serum HO-1 and SLC7A11 in CRF patients is decreased,and the ACSL4 expression is increased,which is closely related to cardiovascular events,and the combined detection of three indexes has high value in predicting cardiovascular events in CRF patients.
4.Ultrasonic parameters of diaphragm motion combined with BODE index for predicting acute exacerbation of chronic obstructive pulmonary disease
Fangxin LIU ; Yongfeng REN ; Jian LI ; Shanshan WANG ; Lifang CAO ; Zhaojie CHEN
Chinese Journal of Medical Imaging Technology 2025;41(1):90-93
Objective To observe the value of ultrasonic parameters of diaphragm motion combined with BODE index for predicting acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Eighty COPD patients were retrospectively collected and divided into stable group(n=45)and acute exacerbation group(n=35).Ultrasonic parameters of diaphragm motion,including diaphragm excursion(DE)under quiet breathing(QB)and deep breathing(DB),i.e.DEQB and DEDB were measured.The general data,ultrasound parameters of diaphragm motion,and BODE index scores were compared between groups.Then logistic regression analysis was used to identify factors which could be used to independently predict acute exacerbations of COPD.The predicting performance of ultrasound parameters of diaphragm motion,BODE index and their combination were evaluated with receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Compared with stable COPD group,acute exacerbation group had higher BMI and BODE index scores(both P<0.05),as well as larger DEQB but smaller DEDB(both P<0.05).DEDB and BODE index were both independent predicting factors of acute exacerbation of COPD,while increased DEDB indicated decreased risk of acute exacerbation(OR[95%CI]=0.673[0.493,0.918],P<0.05),whereas increased BODE index suggested higher risk(OR[95%CI]=3.678[1.061,12.746],P<0.05).AUC for DEDB and BODE index alone for predicting acute exacerbation of COPD was 0.788 and 0.799,respectively,and of their combination was 0.979,significant higher than that of each alone(both P<0.05).Conclusion Ultrasonic parameters of diaphragm motion could be used to evaluate diaphragm function in COPD patients.Combination of DEDB and BODE index had better performances in predicting acute exacerbation of COPD.
5.Construction and effect evaluation of the respiratory rehabilitation calisthenics for school-age children with bronchial asthma
Xixuan LIU ; Yulin LIU ; Sha LIU ; Fan YANG ; Xiaohong XIE ; Zijuan WANG ; Lifang LIU ; Hongyu WEI
Chinese Journal of Nursing 2025;60(9):1043-1050
Objective To construct the respiratory rehabilitation calisthenics for school-age children with asthma,and evaluate its effects,in order to provide a guidance for the scientific and effective implementation of respiratory rehabilitation in clinical work.Methods By convenience sampling method,the school-age children with asthma treated in the respiratory outpatient department of a tertiary specialized children's hospital in Chongqing from De-cember 2023 to February 2024 were selected.The children were randomly divided into an experimental group and the control group(25 of each group)by a random number table.Both groups were given routine asthma drug in-halation treatment and health education.Additionally,the experimental group received respiratory rehabilitation calis-thenics training and the control group received conventional aerobic exercise training.After 3-month intervention,the effects of adherence to respiratory rehabilitation training,lung functions,exercise capacity,inspiratory muscle strength and occurrence of adverse events were evaluated between 2 groups.Results 24 children of each group completed the study.After 3-month intervention,the adherence to respiratory rehabilitation training,exercise capacity and in-spiratory muscle strength were improved in the experimental group compared with those in the control group,and all differences were statistically significant(P<0.05).There were no adverse events in both groups.Conclusion The respiratory rehabilitation calisthenics for school-age children with asthma constructed in this study was scientif-ic,feasible and safe,and could improve exercise capacity and inspiratory muscle strength for children with asthma.
6.Analysis of Hearing Loss in Offspring Mice with Chronic Intrauterine Hypoxia
Rifu WEI ; Liwen CHEN ; Ping LIU ; Zhongshou ZHU ; Lifang GUO ; Xiaomei ZENG
Journal of Audiology and Speech Pathology 2025;33(1):62-65
Objective To study the effects and the possible mechanism of the hearing loss of offspring mice with chronic intrauterine hypoxia.Methods Ten healthy SD pregnant mice with SPF level were selected to establish an intrauterine hypoxia model as the hypoxia group,while another ten healthy SD pregnant mice without hypoxia treatment were selected as the control group.Arterial blood gas analysis was performed on pregnant mice and audi-tory brainstem response(ABR)testing was performed on their offspring after birth,and the results of each group were compared.Results The PaO2 and SaO2 of the hypoxic group were significantly lower than those of in the con-trol group.The hearing loss rate and wave Ⅲ response threshold of the offspring mice of the hypoxia group were significantly higher than those of in the control group at 21 and 56 days,but over time,the hearing loss rate and wave Ⅲ response threshold of the hypoxia group improved compared to before.Although some offspring mice in the hypoxic group at 21 day and 56 day had normal Ⅲ wave response thresholds,their wave Ⅱ and Ⅲ latency,as well as the latency between Ⅰ-Ⅱ,Ⅱ-Ⅲ,and Ⅰ-Ⅲ,were still significantly higher,while the amplitude of wave Ⅲ and the ratio of Ⅲ/Ⅰ were significantly lower than those of in the control group during the same period.For hypoxic off-spring mice with abnormal wave Ⅲ response threshold at 21 days and normal wave Ⅲ response threshold at 56 days,the latency of waves Ⅱ and Ⅲ,as well as the latency between Ⅰ-Ⅱ,Ⅱ-Ⅲ,and Ⅰ-Ⅲ were significantly higher,while the amplitude of wave Ⅲ and the ratio of Ⅲ/Ⅰ were significantly lower than those of in the control group and hypoxic group with normal wave Ⅲ response thresholds at 21 days and 56 days.The hearing loss of offspring mice in the hypoxia group was mainly bilateral.Conclusion Chronic intrauterine hypoxia can lead to varying degrees of hearing loss,but this type of hearing loss has a certain degree of retrogression in the early stages,and the body can undergo limited developmental compensation and repair.
7.Mass spectral database-based methodologies for the annotation and discovery of natural products.
Fengyao YANG ; Zeyuan LIANG ; Haoran ZHAO ; Jiayi ZHENG ; Lifang LIU ; Huipeng SONG ; Guizhong XIN
Chinese Journal of Natural Medicines (English Ed.) 2025;23(4):410-420
Natural products (NPs) have long held a significant position in various fields such as medicine, food, agriculture, and materials. The chemical space covered by NPs is extensive but often underexplored. Therefore, high-throughput and efficient methodologies for the annotation and discovery of NPs are desired to address the complexity and diversity of NP-based systems. Mass spectrometry (MS) has emerged as a powerful platform for the annotation and discovery of NPs. MS databases provide vital support for the structural characterization of NPs by integrating extensive mass spectral data and sample information. Additionally, the released annotation methodologies, based on a variety of informatics tools, continuously improve the ability to annotate the structure and properties of compounds. This review examines the current mainstream databases and annotation methodologies, focusing on their advantages and limitations. Prospects for future technological advancements are then discussed in terms of novel applications and research objectives. Through a systematic overview, this review aims to provide valuable insights and a reference for MS-based NPs annotation, thereby promoting the discovery of novel natural entities.
Biological Products/chemistry*
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Mass Spectrometry/methods*
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Databases, Factual
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Drug Discovery/methods*
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Humans
8.Safety and efficacy of a new single-needle dialysis model in maintenance hemodialysis patients
Bin ZHAO ; Lihong ZHANG ; Shen ZHAN ; Lifang LIU ; Wei LIU ; Shanshan GUO ; Guanghui XIAO ; Yuzhu WANG
Chinese Journal of Nephrology 2025;41(2):125-127
The study was a prospective observational study. A total of 24 patients who underwent maintenance hemodialysis (MHD) at Haidian Hospital in Beijing from May 2024 to June 2024 were included as the study subjects. The safety and efficacy of a new single-needle dialysis in MHD patients were evaluated. The reasons for using single-needle dialysis included waiting for the maturity of internal fistula(7 cases, 29.17%), autogenous arteriovenous fistula thrombosis occurred (6 cases, 25.00%), puncture difficulty occurred (7 cases, 29.17%), and pain sensitivity or elderly (4 cases, 16.67%). The results showed that the average blood flow was (155.65±5.90) ml/min, total blood volume was (35.92±2.65) L during single-needle dialysis. One patient had slight puncture leakage, and the puncture success rate was 95.83%. Relevant indicators of dialysis adequacy showed that the average urea clearance (Kt/V) was 0.90±0.42, urea reduction ratio was 58.31%±7.93%, and online real-time Kt/V monitoring average value was 0.98±0.55. The results suggest that the application of the new improved single-needle dialysis mode in MHD patients is safe and effective.
9.Adverse reaction surveillance analysis of domestic human papillomavirus vaccines with different production processes
Haibo WANG ; Yu LIU ; Shuchan CHENG ; Wenfei TAO ; Chunfang HU ; Lifang ZHOU ; Bangjun LYU ; Min XU ; Jieqiong HUANG
Chinese Journal of Preventive Medicine 2025;59(11):1952-1957
This study aims to compare the vaccination rates and incidence of adverse reaction rates following administration of two domestically produced human papillomavirus (HPV) vaccines in individuals aged 9-30 years,investigate the impact of distinct manufacturing processes and vaccination schedules on adverse reaction rates. From November 2023 to June 2024, the Immunization Planning Department of Liuzhou Center for Disease Control and Prevention conducted a single-center, randomized, open-label, parallel-group trial using community-based recruitment of eligible participants aged 9 to 30 years. Participants were randomly assigned to receive either of two domestically produced HPV vaccines (Walrinvax or Cecolin). As specified in the vaccine package inserts, subjects were stratified into a two-dose regimen group (aged 9-14 years) and a three-dose regimen group (aged 15-30 years). Vaccination rates were recorded, and adverse reactions within 0-30 days post-vaccination were monitored. The results showed that a total of 400 participants were enrolled. Both the full vaccination rate and the timely completion rate were significantly higher in the two-dose regimen group compared to the three-dose regimen group (Fisher′s exact test, P<0.01; χ2=7.06, P<0.01). A total of 985 doses were administered. The overall adverse reaction rate was 18.78% (185/985), with local and systemic reactions occurring at 8.02% (79/985) and 10.76% (106/985), respectively. The most frequent adverse reactions were injection site pain (4.97%, 49/985) and fever (4.47%, 44/985). No grade 4 or special-interest adverse events were reported.The incidence of adverse reactions for the two domestic HPV vaccines with different production processes (at 0/6 months) was 13.96% (55/394) and 17.46% (69/395) respectively, with no statistically significant difference (χ2=1.83, P>0.05).The adverse reaction rate was significantly lower in the 9-14 years group (9.77%) compared the 15-30 years group (24.91%)(χ 2=35.67, P<0.01). In conclusion, both domestic HPV vaccines demonstrated a favorable safety profile in the 9-30 years age group, with mostly mild adverse reactions. Compared to the three-dose schedule (15-30 years group), the two-dose HPV vaccination schedule (9-14 years group) significantly reduced the incidence of adverse reactions and improved vaccination compliance.
10.Analysis of serum bile acid profiles in patients with hepatitis B virus infection complicated with liver cirrhosis
Wang ZHANG ; Jia LIU ; Aixia LIU ; Jie SUN ; Lifang XIA ; Bo LI ; Boan LI
Chinese Journal of Experimental and Clinical Virology 2025;39(4):419-426
Objective:By analyzing the concentration distribution and hydrophilic/hydrophobic proportion differences of 15 bile acid subtypes in the serum of patients with hepatitis B virus(HBV)infection complicated with liver cirrhosis and primary biliary cholangitis(PBC)complicated with liver cirrhosis,this study aims to explore the potential associations between bile acid metabolism and these diseases,providing a reference basis for identifying disease-specific metabolic fingerprints in the diagnosis,treatment,and prognosis of liver diseases. Furthermore,building on the pharmacological mechanisms of ursodeoxycholic acid(UDCA)in the treatment of PBC,this research investigates potential therapeutic applications of bile acid drugs in HBV infection.Methods:A retrospective analysis method was adopted. We enrolled 27 HBV infection complicated with liver cirrhosis patients and 59 PBC complicated with liver cirrhosis patients who received outpatient or inpatient treatment at the Fifth Medical Center of PLA General Hospital from November 2024 to April 2025. The general data and routine clinical laboratory data of the two groups of patients were collected and analyzed. Using the ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UHPLC-QqQ-MS/MS)platform,precise quantification and differential analysis of 15 bile acid subtypes were performed in serum samples. Partial least squares discriminant analysis(PLS-DA)was employed to perform discriminant analysis on serum bile acid profiles data between the two groups,and variable importance in projection(VIP)values were calculated to identify key bile acid subtypes that could differentiate the two diseases. Box plots were constructed to analyze proportion differences in serum hydrophilic and hydrophobic bile acids between the two groups,aiming to explore potential associations between bile acid metabolism and the diseases.Results:The HBV infection group and the PBC group exhibited similar impairment of routine liver function parameters. The HBV infection group had higher serum concentrations of cholic acid(CA),chenodeoxycholic acid(CDCA)and deoxycholic acid(DCA),but lower concentrations of UDCA,glycoursodeoxycholic acid(GUDCA)and tauroursodeoxycholic acid(TUDCA). The score plot generated by the PLS-DA model demonstrated significant differences in bile acid profile characteristics between the two diseases,with VIP values for UDCA,CDCA,GUDCA,TUDCA,and DCA all greater than 1. Box plots demonstrated a higher proportion of hydrophobic bile acids in the bile acid profile of the HBV infection group compared to the PBC group.Conclusion:This study found significant differences in serum bile acid profile characteristics between patients with HBV infection complicated with liver cirrhosis and those with PBC complicated with liver cirrhosis,specific bile acid subtypes such as CDCA and DCA have the potential to become specific metabolic fingerprints for these two diseases. HBV infection group exhibited higher proportion of hydrophobic bile acids in their bile acid profiles compared to PBC group. The characteristic changes in bile acid profiles can reflect the pathological characteristics of liver diseases,and their differences in hydrophilic/hydrophobic bile acids proportion represents a novel dimension independent of traditional liver function indicators,with potential value for disease prognosis assessment. UDCA or its derivatives may hold therapeutic potential for HBV infection patients with liver cirrhosis who exhibit accumulation of hydrophobic bile acids.

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