1.Association of traditional Chinese medicine syndromes with blood lipid profiles and cardiovascular prognosis in post-percutaneous coronary intervention atherosclerotic cardiovascular disease patients: a prospective cohort study
Huangyu XU ; Qian LI ; Haozhe XIONG ; Weidong HONG ; Xinyi ZHOU ; Xiaoyan LU ; Xiaoli LIU ; Xinrong FAN
Digital Chinese Medicine 2026;9(1):91-102
Objective:
Patients with atherosclerotic cardiovascular disease (ASCVD) following percutaneous coronary intervention (PCI) are classified as very-high-risk individuals in cardiovascular disease (CVD) risk stratification. The distribution pattern of traditional Chinese medicine (TCM) syndromes in this patient population, as well as its association with blood lipid profiles and clinical prognosis, remains unclear. The present prospective cohort study aims to investigate these correlations, thereby providing insights to enrich the research fields.
Methods:
We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1, 2020 and December 31, 2022. Demographics and clinical characteristics, signs and symptoms defining each TCM syndrome, and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events (MACEs). We analyzed the correlation between TCM syndromes, blood lipid profiles, and MACEs, and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression. The analyses were based on detailed baseline and one-year follow-up data.
Results:
A per-protocol analysis was performed on 586 patients with complete data ultimately. During the one-year follow-up, 174 patients (29.69%) experienced a MACE. We performed statistical analyses on comorbidities, medication, and biochemical indicators across groups defined by TCM syndrome differentiation. When comparing different TCM syndromes, no significant differences were found in age, body mass index (BMI), history of revascularization, comorbidities, family history of CVD, smoking or drinking, or statin intensity (P > 0.05). Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol (TC, 5.27 ± 1.18 mmol/L, P < 0.001), triglyceride (TG, 1.96 ± 1.33 mmol/L, P = 0.008), low-density lipoprotein cholesterol (LDL-C, 3.35 ± 0.79 mmol/L, P < 0.001), and high-density lipoprotein cholesterol (HDL-C, 1.24 ± 0.81 mmol/L, P < 0.001) compared with those with other TCM syndromes combined. A multivariable logistic regression model was constructed to predict MACEs. The model included TCM syndrome type [with intertwined phlegm and blood stasis as a predictor, adjusted odds ratio (OR) = 1.413, 95% confidence interval (CI): 0.517 – 3.864, P = 0.501], age (adjusted OR = 0.97, 95% CI: 0.955 – 1.001, P = 0.057), male gender (adjusted OR = 0.698, 95% CI: 0.416 – 1.170, P = 0.173), TC (adjusted OR = 1.004, 95% CI: 0.513 – 1.965, P = 0.990), and LDL-C (adjusted OR = 5.825, 95% CI: 2.214 – 15.326, P < 0.001). This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients [the area under the receiver operating characteristic (ROC) curve (AUC) = 0.865, 95% CI: 0.816 – 0.914].
Conclusion
The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C. The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters (TC and LDL-C) shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI, underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.
2.Pathogenesis and Treatment Strategy of "Macrocirculation-Microcirculation" Uncoupling in Sepsis:from the Perspective of "Deep Heat,Deep Syncope"
Xinyi XU ; Yuyang LAN ; Xinyue WANG ; Ying GAO ; Ziqi SHAN ; Xiaokun YANG ; Lu XIAO
Journal of Traditional Chinese Medicine 2026;67(13):1403-1408
By reviewing modern research and integrating clinical practice, this paper interprets the correlation between "deep heat, deep syncope" and the "macrocirculation-microcirculation" uncoupling in sepsis, alongside its clinical applications in sepsis prevention and treatment. It is considered that "deep heat" corresponds to peripheral vasodilation and the hypermetabolic state at the macrocirculation level, whereas "deep syncope" manifests as hypoperfusion and impaired oxygen utilization at the microcirculation level. These two states interact detrimentally, forming the core contradiction of macrocirculation-microcirculation uncoupling in sepsis. Based on the traditional Chinese medicine (TCM) connotations of "deep heat, deep syncope" and modern medical research, this paper elucidates the systemic pathological evolution of sepsis from the inflammatory cascade to impaired oxygen utilization. Accordingly, the following therapeutic principles are proposed. In the early stage, it is suggested to clear heat and drain fire to vent the constrained yang. In the progressive stage, the focus is put on unblocking the lower jiao (焦) and expelling stasis to dredge the vessels and collaterals. In the recovery stage, the method of regulating and harmonizing yin and yang can be used to smooth the flow of qi and blood.
3.Fecal microbiota transplantation for the treatment of cirrhotic ascites with chronic diarrhea: A case report
Dan ZHAO ; Jiaru ZHAO ; Honghong CAO ; Qiaoli GUO ; Wei WU ; Xinyi ZHANG ; Cuiping XU ; Jie ZHANG
Journal of Clinical Hepatology 2026;42(6):1383-1387
Fecal microbiota transplantation (FMT) has been widely used in the treatment of gastrointestinal disorders, particularly Clostridium difficile infection, while there are few reports of its application in the diagnosis and treatment of cirrhotic ascites. This article reports a case of a patient with cirrhotic ascites and chronic diarrhea who received FMT with oral capsules, demonstrating significant short-term efficacy without any adverse reactions, in order to provide a reference for the application of FMT in the treatment of liver diseases.
4.Metabolic characteristics and related influencing factors in patients with diabetic retinopathy
Siman LIU ; Xinyi SUN ; Jing GE ; Xu YU ; Junjun MIAO
Chinese Journal of Clinical Medicine 2026;33(4):636-642
Objective To explore the metabolic characteristics and related factors in patients with diabetic retinopathy (DR). Methods A retrospective study was conducted on the clinical data of 467 diabetic patients hospitalized at the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to September 2024. The patients were divided into the DR group (n=150) and the non-DR group (n=317). Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using a transient elastography device, and graded into five levels. Basic data, LSM and CAP grading, and metabolic indicators were compared between the two groups. Univariate and multivariate logistic regression analyses were applied to identify factors influencing DR. Results Patients in the DR group were older than those in the non-DR group (P<0.001). Compared with the non-DR group, fasting blood glucose (FBG), glycated hemoglobin A1C (HbA1C), and triglyceride (TG) levels were higher, while low-density lipoprotein cholesterol (LDL-C) was lower in the DR group (P<0.05). Significant differences in LSM grading were observed between the two groups (P=0.006). Multivariate logistic regression analysis revealed that LSM grading (grade 2: OR=2.127, P=0.002; grade 3: OR=2.344, P=0.030; grade 4: OR=2.960, P=0.038), FBG (OR=1.233, P<0.001), and serum creatinine (OR=1.013, P=0.006) were independent factors associated with DR. Conclusions FBG, serum creatinine, and LSM are related factors of DR. In clinical practice, attention should be paid to the coordinated management of blood glucose control, renal function monitoring, and liver fibrosis assessment, with early interventions to reduce the risk of DR.
5.Overview of the amendments and revisions to the General Technical Requirements adopted by the Volume Ⅳ of the Chinese Pharmacopoeia 2025 Edition
ZHANG Jun ; NING Baoming ; WEI Shifeng ; SHEN Haoyu ; SHANG Yue ; ZHU Ran ; XU Xinyi ; CHEN Lei ; LIU Tingting ; MA Shuangcheng
Drug Standards of China 2025;26(1):034-044
To introduce the general thinking, guidelines, work objectives and elaboration process of the general technical requirements adopted by volume Ⅳ of the Chinese Pharmacopoeia 2025 Edition, and to summarize and figure out the main characteristics on dosage forms, physico-chemical testing, microbial and biological testing, reference standards and guidelines The newly revised general chapters of pharmacopoeia give full play to the normative and guiding role of the Chinese Pharmacopoeia standard, track the frontier dynamics of international drug regulatory science and the elaboration of monographs, expand the application of state-of-the-art technologies, and steadily promote the harmonization and unification with the ICH guidelines; further enhance the overall capacity of TCM quality control, actively implement the 3 R principles on animal experiments, and practice the concept of environmental-friendly; replace and/or reduce the use of toxic and hazardous reagents, strengthen the requirements of drug safety control This paper aims to provide a full-view perspective for the comprehensive, correct understanding and accurate implementation of general technical requirements included in the Chinese Pharmacopoeia 2025 Edition.
6.Additions and revisions of general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition Volume Ⅳ
XU Xinyi ; WEI Shifeng ; ZHANG Qiming ; HE Langchong ; ZHANG Jun ; MA Shuangcheng
Drug Standards of China 2025;26(1):045-050
Objective: To provide reference for the correct understanding and accurate implementation of the general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition Volume Ⅳ.
Methods: Introduce the main characteristics and content of the additions and revisions of the general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition Volume Ⅳ.
Results: The general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition are more harmonized with the relevant guidelines of the ICH Q series, and the inclusion of advanced and mature instrument analysis technology standards and analysis method standards related to drug safety, efficacy, and quality controllability is further increased.
Conclusion: The general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition have provided a more convenient new bridge for China’s drugs to go international, standardized testing technology support for achieving full process quality control, and better meet the needs of drug research and development, production, quality control, and supervision in China.
7.Phenomics of traditional Chinese medicine 2.0: the integration with digital medicine
Min Xu ; Xinyi Shao ; Donggeng Guo ; Xiaojing Yan ; Lei Wang ; Tao Yang ; Hao LIANG ; Qinghua PENG ; Lingyu Linda Ye ; Haibo Cheng ; Dayue Darrel Duan
Digital Chinese Medicine 2025;8(3):282-299
Abstract
Modern western medicine typically focuses on treating specific symptoms or diseases, and traditional Chinese medicine (TCM) emphasizes the interconnections of the body’s various systems under external environment and takes a holistic approach to preventing and treating diseases. Phenomics was initially introduced to the field of TCM in 2008 as a new discipline that studies the laws of integrated and dynamic changes of human clinical phenomes under the scope of the theories and practices of TCM based on phenomics. While TCM Phenomics 1.0 has initially established a clinical phenomic system centered on Zhenghou (a TCM definition of clinical phenome), bottlenecks remain in data standardization, mechanistic interpretation, and precision intervention. Here, we systematically elaborates on the theoretical foundations, technical pathways, and future challenges of integrating digital medicine with TCM phenomics under the framework of “TCM phenomics 2.0”, which is supported by digital medicine technologies such as artificial intelligence, wearable devices, medical digital twins, and multi-omics integration. This framework aims to construct a closed-loop system of “Zhenghou–Phenome–Mechanism–Intervention” and to enable the digitization, standardization, and precision of disease diagnosis and treatment. The integration of digital medicine and TCM phenomics not only promotes the modernization and scientific transformation of TCM theory and practice but also offers new paradigms for precision medicine. In practice, digital tools facilitate multi-source clinical data acquisition and standardization, while AI and big data algorithms help reveal the correlations between clinical Zhenghou phenomes and molecular mechanisms, thereby improving scientific rigor in diagnosis, efficacy evaluation, and personalized intervention. Nevertheless, challenges persist, including data quality and standardization issues, shortage of interdisciplinary talents, and insufficiency of ethical and legal regulations. Future development requires establishing national data-sharing platforms, strengthening international collaboration, fostering interdisciplinary professionals, and improving ethical and legal frameworks. Ultimately, this approach seeks to build a new disease identification and classification system centered on phenomes and to achieve the inheritance, innovation, and modernization of TCM diagnostic and therapeutic patterns.
8.Genetic Homology Analysis of Bloodstream Infection Secondary to Intestinal Colonization with Carbapenem-Resistant Klebsiella Pneumoniae
Xinyue LI ; Hongjuan ZHANG ; Xiaoyan ZHU ; Meijia HUANG ; Yunmin XU ; Xundie LI ; Xinyi ZHENG ; Shaoxuan LI ; Bin SHAN
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1138-1147
To investigate the genetic relatedness between carbapenem-resistant A retrospective analysis was conducted on clinical data from patients screened for carbapenem-resistant Among 12 878 patients screened for CRE, 60 (0.47%) were identified with intestinal CRKP colonization. Of these, 6 (10.0%) developed bloodstream infections, with an all-cause mortality rate of 66.7% (4/6) during hospitalization. The predominant strain type among paired isolates was ST11-KL64 producing KPC-2, accounting for 91.7%(11/12) of cases. Except for one patient(with a categorical agreement of 82.6%), colonizing and bloodstream isolates from the same patient showed complete agreement (100% categorical agreement) in antimicrobial susceptibility profiles for all antibiotics except tigecycline. Intraclass correlation coefficients for biofilm formation and siderophore production were both > 0.75 of all paired strains, indicating high phenotypic consistency. Except for one patient, core genome single nucleotide polymorphism (SNP) analysis and phylogenetic reconstruction revealed high genetic homology between colonizing and bloodstream isolates from the same patient (SNP difference < 10). Clonal relatedness was also observed among colonizing strains from different departments (SNP difference < 120). Although the intestinal colonization rate of CRKP is low, it poses a high mortality risk once bloodstream infection occurs. The high consistency in antimicrobial resistance profiles, biofilm formation, siderophore production, and genomic homology between colonizing and bloodstream isolates suggests that intestinal colonization is the direct source of subsequent invasive infection. Enhanced early screening, dynamic monitoring, risk-stratified prevention, and optimized intervention strategies are recommended to reduce the risk of CRKP infection and mortality.
9.Spatial Distribution Patterns and Environmental Influencing Factors of Flavonoid Glycosides in Epimedium sagittatum
Mengxue LI ; Wenmin ZENG ; Yiting WEI ; Fengqin LI ; Shengfu HU ; Xinyi WANG ; Zhangjian SHAN ; Yanqin XU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):217-226
ObjectiveTo explore the spatial distribution patterns of flavonoid glycosides in Epimedium sagittatum and the influences of environmental factors on the accumulation of these components. MethodsThe spatial statistical analysis and GeoDetector model were used to analyze the distribution patterns of epimedin A,epimedin B,epimedin C,icariin,and total flavonoid glycosides in E. sagittatum samples from 92 different production areas in 36 cities of 13 provinces/municipalities/autonomous regions of China,as well as the effects of 28 environmental factors on the accumulation of each component. ResultsThe average content of flavonoid glycosides 64 (69.56%) producing areas and 30 (83.33%) cities met the quality standard of no less than 1.50% of total flavonoid glycosides in the 2020 edition of Chinese Pharmacopoeia.Epimedin A,epimedin B,epimedin C,icariin,and their sum showed significantly high accumulation.The hot spots regions of epimedin A and epimedin B were similar with each other,mainly located in western Hunan,eastern Hubei,eastern Guizhou,and northern Guangxi.The common hot spot areas of epimedin C and total flavonoid glycosides were in western and southwestern Hunan,southern Henan,northern Anhui,eastern Guizhou,and southern Chongqing.The hot spots areas of icariin were in southern Chongqing,western Hunan,and eastern and northeastern Guizhou.The interactions between environmental factors had stronger explanatory power for the accumulation of components than single factors.The strongest single factor and interactive factor affecting the accumulation of epimedin C were precipitation of wettest quarter (q=0.16) and its interaction with temperature seasonality (q=0.35),respectively.The strongest single factor influencing both the accumulation of icariin and total flavonoid glycosides was the precipitation of coldest quarter (q equals 0.15 and 0.22,respectively).The strongest interactions were observed between precipitation of coldest quarter and gravel content (q=0.34),as well as between precipitation of coldest quarter and aspect (q=0.35). ConclusionThirteen cities,including Zhumadian and Nanyang in Henan,Huaihua,Shaoyang,and Zhangjiajie in Hunan,and Zunyi,Qiandongnan,and Tongren in Guizhou,were hot spots of total flavonoid glycosides in E.sagittatum.Precipitation,gravel content,temperature seasonality,and aspect significantly influence the accumulation of flavonoid glycosides in E.sagittatum.This study provides reference for the utilization and production zoning of E.sagittatum.
10.Research advances in prognostic score models and biomarkers for acute-on-chronic liver failure
Xinyi XU ; Xia YU ; Huilan TU ; Xiaohan QIAN ; Yida YANG ; Yu SHI
Journal of Clinical Hepatology 2025;41(6):1030-1036
Acute-on-chronic liver failure (ACLF) is a complex clinical syndrome, and early identification and accurate prognostic evaluation are of great importance for patient treatment and management. In recent years, with in-depth research on the pathogenesis of ACLF, multiple prognostic biomarkers have been proposed and used in clinical practice. This article systematically reviews the research advances in prognostic biomarkers for ACLF from the aspects of clinical predictive models, immunological biomarkers, metabolic biomarkers, genetic and epigenetic biomarkers, microbiome-related biomarkers, and emerging technologies such as artificial intelligence and multi-omics, and it also discusses the value and application prospects of these biomarkers in the prognostic evaluation of ACLF and proposes future research directions, in order to provide a scientific and comprehensive reference for clinicians, guide individualized treatment and management of ACLF patients, and finally improve the clinical outcomes of patients.

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