1.Herbal Textual Research on Cynanchi Atrati Radix et Rhizoma in Famous Classical Formulas
Xiaoqi JING ; Minna GUO ; Haihua WANG ; Juan LI ; Fusheng ZHANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):208-216
This article systematically reviews and verifies the name, origin, production area, quality evaluation, harvesting, processing and other aspects of Cynanchi Atrati Radix et Rhizoma(CARR) by consulting relevant ancient and modern literature, in order to provide a basis for the development and utilization of famous classical formulas containing this herb. Through textual research, Baiwei has been the official name for CARR, though it also bears alternative names such as Chuncao, Popo Zhenxianbao, Longdan Baiwei. The mainstream base is the roots and rhizomes of Cynanchum atratum. Historical records indicate primary producing areas include Shandong, Anhui, Jiangsu, Shaanxi and Shanxi. Since the late Ming dynasty, varieties from Juxian, Yishui and Rizhao in Shandong have been highly regarded as authentic, commonly known as eastern Baiwei. Since modern times, its quality has been summarized as fine, slender, and straight fibrous roots, pale yellow exterior, whiter interior, and dryness with easy breakability are considered superior. The harvesting time before the Song dynasty was on the third day of the third lunar month, but after the Song dynasty, harvesting was possible in both spring and autumn. The initial processing methods of CARR in ancient times included drying in the shade, removing Lu(the little rhizomes which are on tap of roots), and removing mustaches, modern methods involve washing and sun-drying. During the Northern and Southern dynasties, processing methods included steaming. In the Song dynasty, drying and light stir-frying were predominant, while wine washing emerged in the Ming dynasty. Modern practices primarily involve using raw, stir-frying or honey processing. Regarding the medicinal properties of CARR, both ancient and modern texts agree it has a bitter and salty taste and is non-toxic. Records prior to the Qing dynasty predominantly describe its nature as extremely cold, while mainstream herbal texts after the Qing dynasty generally characterize it as cold. Before the Ming dynasty, there were no records of its meridian tropism. It was not until the Qing dynasty that it was recorded in the lung meridian. Modern records mainly refer to the stomach, liver, and kidney meridians. Throughout history, its main functions have been to clear heat, diuresis, nourish Yin, and replenish essence, primarily treating Yin deficiency and fever syndrome. Based on the research results, it is suggested that when developing famous classical formulas containing CARR, the dried roots and rhizomes of C. atratum can be selected as its medicinal source. If there are no specific processing requirements, raw products can be selected as medicine. If the processing requirements are specified, corresponding processed products can be selected as medicine according to the original formula requirements.
2.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.
3.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.
4.Discussion on the generative principles and moral cognitive capacity of artificial life
Chinese Medical Ethics 2026;39(1):12-21
Artificial life is the goal pursued by cognitive philosophy, cognitive science, and artificial intelligence, yet its realization has consistently encountered challenge. The generative mechanisms of artificial life include self-organization, emergence, and agency, all of which are difficult to precisely grasp in the cognitive paradigm. Evolutionary biology demonstrates that natural life possesses extraordinary adaptability. For artificial artifacts, the way to endow them with life-like characteristics involves first transforming them into self-organizing systems with emergence, and then evolving them into embodied agents possessing agency and moral cognitive capacity. This process reveals the functional and informational properties of artificial life, manifesting its adaptive representational character.
5.Herbal Textual Research on Piperis Longi Fructus in Famous Classical Formulas
Haihua WANG ; Xiaoqi JING ; Juan LI ; Dabang REN ; Fusheng ZHANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):210-219
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, producing area, harvesting and processing, nature, flavor and efficacy of Piperis Longi Fructus by referring to the materia medica, medical books, and prescription books of past dynasties, combined with the relevant modern literature, in order to provide a basis for the development and utilization of famous classical formulas containing this herb. According to the herbal textual research, the name of Piper longum first appeared in Nanfang Caomuzhuang, and it also has other aliases such as Biboli, Halou, and Hujiaohua. Historically, the origin of Piperis Longi Fructus has been P. longum of the Piperaceae family. In ancient times, both the fruit and root were used as medicine, and since the Republic of China, the fruit has been mainly used as medicine. The medicinal part is the dried, nearly ripe or ripe fruit spikes. Piperis Longi Fructus is native to India and has been introduced into China since the Tang dynasty. In the Ming dynasty, Bencao Pinhui Jingyao clearly stated that the genuine producing area was "Duanzhou", present-day Zhaoqing in Guangdong province. Nowadays, it is planted in Guangdong, Guangxi, Hainan, Yunnan and other regions. Historically and currently, harvesting occurs in autumn. The ancient processing method uniformly involved removing the stems, soaking in the sourest vinegar overnight, baking, and scraping off the peels and grains with a knife until clean. In modern times, impurities are removed, and it is dried in the sun and crushed when used. The properties, functions and applications of P. longum are basically the same in ancient and modern times. It tastes pungent, is warm in nature, and non-toxic. It has the effects of warming the middle-jiao to dispel cold, lowering Qi and relieving pain, and is used for cold pain in the epigastrium and abdomen, vomiting, diarrhea, chest pain, headache, and toothache. Based on the research results, it is recommended that when developing famous classical formulas containing Piperis Longi Fructus, the dried nearly ripe or ripe fruit spikes of P. longum should be used. If there are no clear processing requirements, it is recommended to use the raw products for medicinal use, and the specific processing methods can refer to the relevant requirements under Piperis Longi Fructus in the 2025 edition of the Pharmacopoeia of the People's Republic of China. If processing requirements such as soaking in vinegar and peeling are clearly specified, it is recommended to follow the ancient methods.
6.Influencing factors of significant corneal astigmatism in pterygium patients during the perioperative period
Shiru CHAI ; Xiaofen ZHENG ; Hua YU ; Zhen LI ; Yuguo KANG
International Eye Science 2026;26(4):683-686
AIM: To explore the factors associated with significant corneal astigmatism during the perioperative period in patients with pterygium. METHODS: Patients with primary pterygium presenting at Shanxi Eye Hospital between February and June 2025 were enrolled. All patients underwent medical history collection. Pre- and postoperative data were obtained using Pentacam, anterior segment photography, Image J software, and anterior segment optical coherence tomography(AS-OCT). All patients underwent pterygium excision combined with autologous bulbar conjunctival flap transplantation under local infiltration anesthesia. RESULTS: A total of 76 patients(76 eyes)with pterygium were finally enrolled(30 males, 46 females)with a mean age of 62.2±8.2 y. The mean length of corneal invasion by pterygium was 3.61±0.89 mm, the mean depth of invasion into the anterior corneal surface was 0.15±0.09 mm, and the median area of corneal invasion was 10.25(6.90, 18.75)mm2. The median preoperative corneal astigmatism was 1.50(0.70, 5.45)D. Median astigmatism was 0.8(0.40, 1.28)D at 2 wk postoperatively and 0.60(0.30, 1.15)D at 1 mo postoperatively. Patient age showed a positive correlation with preoperative astigmatism, and with residual astigmatism at 2 wk and 1 mo postoperatively(all P<0.05). The length of corneal invasion was positively correlated with preoperative astigmatism and residual astigmatism at both postoperative timepoints(P<0.01). The depth of invasion showed no significant linear correlation with astigmatism at any stage(P=0.250, 0.761, 0.686). The area of corneal invasion was positively correlated with astigmatism at all stages(P<0.01). Patients were grouped based on significant astigmatism(≥1.0 D)and non-significant astigmatism(<1.0 D), after adjusting for other variables, age(P=0.031)and the area of corneal invasion(P=0.004)were identified as risk factors for significant astigmatism. Pterygium invasion length was not significant factors(P>0.05). Receiver operating characteristic(ROC)analysis showed the highest area under the curve(AUC)for the invasion area(AUC=0.915). CONCLUSION: Significant preoperative corneal astigmatism in pterygium patients is correlated with patient age, the length of corneal invasion, and the area of invasion. The area of pterygium invasion into the cornea is the strongest predictor of significant preoperative corneal astigmatism.
7.Predictive modle for violence risk in hospitalized schizophrenia patients based on support vector machine
Huan LIU ; Peifang SHI ; Kun ZHANG ; Li KANG ; Yan ZHANG ; Long NA ; Binhong WANG ; Meiqing HE
Sichuan Mental Health 2026;39(1):27-35
BackgroundThe violent aggressive behaviors of patients with schizophrenia usually have the characteristics of suddenness, unpredictability, high severity, and great difficulty in prevention. Early identification and accurate assessment of their risk of violent aggression have significant clinical significance. ObjectiveTo construct a predictive model for the violence risk in hospitalized patients with schizophrenia, to identify the key factors influencing the occurrence of violent behavior in these patients, so as to provide references for clinical precise quantitative assessment and early intervention. MethodsA total of 200 patients with schizophrenia who were hospitalized at Taiyuan Psychiatric Hospital from March 2022 to September 2024 and met the diagnostic criteria of the International Classification of Diseases, eleventh edition (ICD-11) were collected to form the modeling cohort. They were randomly divided into a training set (n=140) and a test set (n=60) at a ratio of 7∶3. Based on the least absolute shrinkage and selection operator (LASSO) regression algorithm, the feature variables were screened and dimension-reduced. The support vector machine (SVM) from machine learning was selected for model training and prediction. The discrimination efficacy of the model was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC), accuracy, precision, sensitivity, specificity, F1 value, and Brier value. ResultsLASSO regression screening identified 16 feature variables. Pearson correlation analysis revealed a positive correlation between prior violent behavior frequency and clinical psychiatric symptom scores (r=0.580, P<0.01), a positive correlation between hospitalization compliance and current disease status (r=0.550, P=0.003), and a positive correlation between educational level and family per capita monthly income (r=0.367, P<0.01). The SVM model achieved an AUC of 0.853, accuracy of 0.800, precision of 0.810, sensitivity of 0.895, specificity of 0.636, F1 value of 0.850, and Brier value of 0.168. ConclusionThe SVM model has a relatively high level of applicability and overall predictive performance in the assessment of violent risk in schizophrenia patients, which is helpful for the early identification of violent risks in such patients. [Funded by Specialized Research Project for Enhancing the Competence of Health Professionals in Taiyuan City (number, Y2023006)]
8.Herbal Textual Research on Piperis Longi Fructus in Famous Classical Formulas
Haihua WANG ; Xiaoqi JING ; Juan LI ; Dabang REN ; Fusheng ZHANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):210-219
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, producing area, harvesting and processing, nature, flavor and efficacy of Piperis Longi Fructus by referring to the materia medica, medical books, and prescription books of past dynasties, combined with the relevant modern literature, in order to provide a basis for the development and utilization of famous classical formulas containing this herb. According to the herbal textual research, the name of Piper longum first appeared in Nanfang Caomuzhuang, and it also has other aliases such as Biboli, Halou, and Hujiaohua. Historically, the origin of Piperis Longi Fructus has been P. longum of the Piperaceae family. In ancient times, both the fruit and root were used as medicine, and since the Republic of China, the fruit has been mainly used as medicine. The medicinal part is the dried, nearly ripe or ripe fruit spikes. Piperis Longi Fructus is native to India and has been introduced into China since the Tang dynasty. In the Ming dynasty, Bencao Pinhui Jingyao clearly stated that the genuine producing area was "Duanzhou", present-day Zhaoqing in Guangdong province. Nowadays, it is planted in Guangdong, Guangxi, Hainan, Yunnan and other regions. Historically and currently, harvesting occurs in autumn. The ancient processing method uniformly involved removing the stems, soaking in the sourest vinegar overnight, baking, and scraping off the peels and grains with a knife until clean. In modern times, impurities are removed, and it is dried in the sun and crushed when used. The properties, functions and applications of P. longum are basically the same in ancient and modern times. It tastes pungent, is warm in nature, and non-toxic. It has the effects of warming the middle-jiao to dispel cold, lowering Qi and relieving pain, and is used for cold pain in the epigastrium and abdomen, vomiting, diarrhea, chest pain, headache, and toothache. Based on the research results, it is recommended that when developing famous classical formulas containing Piperis Longi Fructus, the dried nearly ripe or ripe fruit spikes of P. longum should be used. If there are no clear processing requirements, it is recommended to use the raw products for medicinal use, and the specific processing methods can refer to the relevant requirements under Piperis Longi Fructus in the 2025 edition of the Pharmacopoeia of the People's Republic of China. If processing requirements such as soaking in vinegar and peeling are clearly specified, it is recommended to follow the ancient methods.
9.Mechanism of bexarotene in suppressing double hit lymphoma via modulation of the c-Myc pathway: Insights from WGCNA
HE Tiantian1 ; LI Hongyi2 ; GENG Jie3 ; HOU Chuandong2 ; ZHANG Hong4 ; ZHANG Hui1 ; ZHAO Peng5 ; LU Xuechun6 ; HE Peifeng5
Chinese Journal of Cancer Biotherapy 2025;32(7):716-722
[摘 要] 目的:基于加权基因共表达网络分析(WGCNA)探讨贝沙罗汀治疗双打击淋巴瘤(DHL)的分子机制,为DHL治疗提供潜在靶点和实验依据。方法:从基因表达综合数据库(GEO)下载GSE44164和GSE43677表达谱数据集,筛选出差异表达基因(DEG)。采用WGCNA识别与DHL相关的基因模块,构建蛋白质相互作用(PPI)网络以筛选关键基因。通过药物预测平台EpiMed进行关联分析以确定DHL的潜在靶向治疗药物。利用CCK-8法和WB法检测贝沙罗汀对DHL细胞增殖及关键蛋白表达的影响,通过流式细胞术评估贝沙罗汀诱导细胞凋亡的效果。结果:WGCNA识别出与DHL高度相关的碧绿色模块,在PPI网络中筛选出10个枢纽基因,包括COL1A2、COL3A1、MMP2、COL5A2、DCN、BGN、FN1、MMP9、FBN1和LUM。药物关联分析确定贝沙罗汀为潜在治疗药物。体外实验显示,贝沙罗汀显著抑制U2932细胞活力(P < 0.05)、促进细胞凋亡(P < 0.001)、下调细胞中c-Myc和COL1A2的表达(均P < 0.05)。结论:贝沙罗汀可能通过抑制c-Myc信号通路及调控细胞外基质相关基因发挥抗DHL作用,其体内疗效及联合治疗潜力需进一步验证。
10.Effects of combined use of active ingredients in Buyang Huanwu Decoction on oxygen-glucose deprivation/reglucose-reoxygenation-induced inflammation and oxidative stress of BV2 cells.
Tian-Qing XIA ; Ying CHEN ; Jian-Lin HUA ; Qin SU ; Cun-Yan DAN ; Meng-Wei RONG ; Shi-Ning GE ; Hong GUO ; Bao-Guo XIAO ; Jie-Zhong YU ; Cun-Gen MA ; Li-Juan SONG
China Journal of Chinese Materia Medica 2025;50(14):3835-3846
This study aims to explore the effects and action mechanisms of the active ingredients in Buyang Huanwu Decoction(BYHWD), namely tetramethylpyrazine(TMP) and hydroxy-safflor yellow A(HSYA), on oxygen-glucose deprivation/reglucose-reoxygenation(OGD/R)-induced inflammation and oxidative stress of microglia(MG). Network pharmacology was used to screen the effective monomer ingredients of BYHWD and determine the safe concentration range for each component. Inflammation and oxidative stress models were established to further screen the best ingredient combination and optimal concentration ratio with the most effective anti-inflammatory and antioxidant effects. OGD/R BV2 cell models were constructed, and BV2 cells in the logarithmic growth phase were divided into a normal group, a model group, an HSYA group, a TMP group, and an HSYA + TMP group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of inflammatory cytokines such as interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6). Oxidative stress markers, including superoxide dismutase(SOD), nitric oxide(NO), and malondialdehyde(MDA), were also measured. Western blot was used to analyze the protein expression of both inflammation-related pathway [Toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)] and oxidative stress-related pathway [nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)]. Immunofluorescence was used to assess the expression of proteins such as inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1). The most effective ingredients for anti-inflammatory and antioxidant effects in BYHWD were TMP and HSYA. Compared to the normal group, the model group showed significantly increased levels of IL-1β, TNF-α, IL-6, NO, and MDA, along with significantly higher protein expression of NF-κB, TLR4, Nrf2, and HO-1 and significantly lower SOD levels. The differences between the two groups were statistically significant. Compared to the model group, both the HSYA group and the TMP group showed significantly reduced levels of IL-1β, TNF-α, IL-6, NO, and MDA, lower expression of NF-κB and TLR4 proteins, higher levels of SOD, and significantly increased protein expression of Nrf2 and HO-1. Additionally, the expression of the M1-type MG marker iNOS was significantly reduced, while the expression of the M2-type MG marker Arg-1 was significantly increased. The results of the HSYA group and the TMP group had statistically significant differences from those of the model group. Compared to the HSYA group and the TMP group, the HSYA + TMP group showed further significant reductions in IL-1β, TNF-α, IL-6, NO, and MDA levels, along with significant reductions in NF-κB and TLR4 protein expression, an increase in SOD levels, and elevated Nrf2 and HO-1 protein expression. Additionally, the expression of the M1-type MG marker iNOS was reduced, while the M2-type MG marker Arg-1 expression increased significantly in the HSYA + TMP group compared to the TMP or HSYA group. The differences in the results were statistically significant between the HSYA + TMP group and the TMP or HSYA group. The findings indicated that the combined use of HSYA and TMP, the active ingredients of BYHWD, can effectively inhibit OGD/R-induced inflammation and oxidative stress of MG, showing superior effects compared to the individual use of either component.
Oxidative Stress/drug effects*
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Drugs, Chinese Herbal/pharmacology*
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Animals
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Mice
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Glucose/metabolism*
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Cell Line
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Inflammation/genetics*
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Oxygen/metabolism*
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Pyrazines/pharmacology*
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Microglia/metabolism*
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NF-E2-Related Factor 2/immunology*
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NF-kappa B/immunology*
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Toll-Like Receptor 4/immunology*
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Anti-Inflammatory Agents/pharmacology*
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Humans

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