1.Olfactory Receptors Expressed in The Intestine and Their Functions
Pei-Wen YANG ; Meng-Meng YUAN ; Ying ZHOU ; Peng LI ; Gui-Hong QI ; Ying YANG ; Zhong-Yi MAO ; Meng-Sha ZHOU ; Xiao-Shuang MAO ; Jian-Ping XIE ; Yi-Nan YANG ; Shi-Hao SUN
Progress in Biochemistry and Biophysics 2026;53(3):534-549
Olfactory receptors (ORs) form the largest superfamily of G protein-coupled receptors (GPCRs). Traditionally recognized for their role in the nasal olfactory epithelium, where they mediate the sense of smell, accumulating evidence has firmly established their ectopic expression in non-olfactory tissues, including the intestine, lungs, and kidneys. The intestine, as the primary site for nutrient digestion and absorption, harbors a highly complex chemical environment. To adapt to this environment, the gut employs a sophisticated network of “chemosensors” to monitor luminal contents and maintain homeostasis. Among these sensors, intestinal ORs have emerged as crucial functional components, serving as a molecular bridge that connects environmental chemical signals—such as food-derived odorants—to specific physiological responses. This discovery has significantly deepened our understanding of how dietary flavors and compounds influence intestinal physiology at the molecular level. This review systematically summarizes the expression profiles, ligand classification, and biological functions of ORs within the gastrointestinal tract. Studies indicate that intestinal ORs exhibit distinct spatial distribution patterns across different gut segments and display cell-type specificity, particularly within enterocytes and enteroendocrine cells. These receptors function as versatile sensors capable of recognizing a wide variety of ligands, including exogenous dietary components, gut microbiota metabolites such as short-chain fatty acids, and endogenous small molecules like azelaic acid. Upon activation by specific ligands, intestinal ORs trigger intracellular signaling cascades, primarily involving the AC-cAMP-PKA pathway or calcium influx channels. A major focus of this review is to elucidate the molecular mechanisms by which these receptors regulate the secretion of gut hormones. Activation of specific ORs in enteroendocrine cells has been shown to stimulate the release of hormones such as glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and serotonin (5-HT), thereby modulating systemic energy metabolism, glucose homeostasis, and gastrointestinal motility. Furthermore, the review addresses the critical roles of ORs in immune regulation and pathology. Evidence suggests that specific ORs contribute to the maintenance of intestinal immune homeostasis and may offer protection against inflammation. Beyond their involvement in inflammatory responses, ORs such as Olfr78 have been shown to regulate the differentiation and function of intestinal endocrine cells. Similarly, Olfr544 has been demonstrated to alleviate intestinal inflammation by remodeling the gut microbiome and metabolome. These findings collectively suggest that specific ORs hold promise as therapeutic targets for mitigating intestinal inflammation and maintaining gut homeostasis. Additionally, the review explores the emerging role of ORs in cancer. Although OR expression is often downregulated in tumor tissues compared to normal mucosa, activation of specific ORs by certain ligands can inhibit tumor cell proliferation and migration and induce apoptosis via pathways such as MEK/ERK and p38 MAPK. Conversely, other receptors, such as OR7C1, may serve as biomarkers for cancer-initiating cells. In conclusion, intestinal ORs represent a vital component of the gut’s sensory network. The review also discusses the translational potential of these findings. By elucidating the precise pairing relationships between dietary components and specific ORs, novel therapeutic strategies could be developed. Intestinal ORs may thus emerge as promising targets for nutritional and pharmacological interventions in metabolic diseases, inflammatory bowel diseases, and malignancies.
2.Traditional Chinese Medicine Promotes Neoangiogenesis in Treatment of Vascular Dementia by Benefiting Qi, Activating Blood Circulation, and Resolving Blood Stasis: A Review
Zhenlong ZHOU ; Yu DUAN ; Hongyu SHA ; Haichun ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):318-328
Vascular dementia (VaD) is a cognitive dysfunction syndrome caused by cerebrovascular disease and is the second most common type of dementia worldwide, following Alzheimer's disease. The pathological mechanisms of VaD are complex, involving multiple biological processes, including angiogenesis, neuroinflammation, apoptosis, and oxidative stress. Among these, angiogenesis is a key process in VaD pathology and is primarily regulated through the vascular endothelial growth factor (VEGF) signaling pathway. In recent years, traditional Chinese medicine (TCM) has gradually gained attention in the treatment of VaD, particularly the therapeutic approach of benefiting Qi, activating blood circulation, and resolving blood stasis, which has demonstrated unique advantages in clinical practice. This method, based on the TCM theory of Qi and blood, emphasizes improving the pathological state of ''blood stasis'' by harmonizing the circulation of Qi and blood, and its scientific basis has been increasingly elucidated by modern pharmacological studies. This article systematically integrates the TCM concept of ''removing stasis to promote regeneration'' with the modern medical mechanism of neoangiogenesis and reviews the current research on promoting neoangiogenesis through the benefiting Qi, activating blood circulation, and resolving blood stasis in VaD treatment. It covers research progress on single Chinese medicine and compound formulas that promote neoangiogenesis, reduce apoptosis, and improve cerebral hemodynamics through multi-target and multi-pathway synergistic effects. Furthermore, this article explores the therapeutic approach of combining acupuncture and moxibustion with Chinese medicine formulas, breaking through the traditional single-treatment model. The synergistic treatment of acupuncture and herbal medicine not only enhances neoangiogenesis but also improves cognitive function and quality of life in VaD patients via multiple pathways. By comparing the advantages and limitations of modern medicine and TCM in VaD treatment, this article notes that while modern medicine excels in elucidating pathological mechanisms and targeted therapies, it is limited in overall regulation and multi-target interventions. TCM, through the comprehensive effects of multiple components and targets, is better suited to address the complex pathological features of VaD. However, current research on TCM for VaD still has limitations, including incompletely clarified mechanisms and insufficient clinical studies. Therefore, future research should further integrate multidisciplinary approaches, such as modern pharmacology and molecular biology, to deeply explore TCM resources and investigate diverse interdisciplinary collaborative treatment models, providing new ideas and strategies for VaD therapy.
3.Mechanistic study on alleviation of Schistosoma japonicum infection-induced hepatic damages by macrophage efferocytosis
Yuxin ZHANG ; Junyao SHEN ; Weijie XUE ; Chenxu MAO ; Ziling WANG ; Zhigang LEI ; Sha ZHOU ; Chuan SU
Chinese Journal of Schistosomiasis Control 2026;38(3):274-286
Objective To investigate the development, role, and regulatory mechanism of macrophage efferocytosis in the liver of hosts infected with Schistosoma japonicum. Methods The expression of efferocytosis-related gene like efferocytosis receptors, efferocytosis-related bridging molecules,“eat me” signal and “don’t eat me” signal was detected in the livers of patients and mice infected with S. japonicum in the Gene Expression Omnibus (GEO) database. Ten wild-type (WT) male mice (6 ~ 8 weeks old, weighing 20 ~ 25 g) were randomly divided into a Schistosoma japonicum infection (SJ) group and a normal control (NC) group, with 5 mice in each group. The efferocytosis of neutrophils and T cells by liver macrophages was detected in mice from SJ group and NC group using flow cytometry and immunofluorescence assay, respectively. The expression of efferocytosis-related Mer receptor tyrosine kinase (MerTK) and Axl receptor tyrosine kinase (Axl) proteins was determined in mouse liver tissues using Western blotting assay, and the proportion of MerTK+ macrophages and the average fluorescence intensity of macrophage MerTK were detected in mouse livers using flow cytometry. Changes in liver granulomas and fibrosis were observed in mice infected with S. japonicum following injection of efferocytosis inhibitors, and S. japonicum-infected mice without injection of efferocytosis inhibitors served as controls. Bone marrow-derived macrophages (BMDMs) were isolated from macrophage scavenger receptor class A (SR-A) conditional knockout (CKO) and wild-type (WT) mice, and changes in apoptotic neutrophils were detected in SR-A CKO mouse macrophages in vitro using flow cytometry. Then, BMDMs was divided into the WT mono-culture group, the WT and apoptotic neutrophils co-culture group, the SR-A CKO mono-culture group, and the SR-A CKO and neutrophils co-culture group, and the expression of MerTK and Axl was quantified in vitro using Western blotting and real-time quantitative PCR (RT-qPCR) assays during neutrophil efferocytosis. The efferocytosis of neutrophils and T cells by mouse liver macrophages was detected in the SR-A CKO SJ group and the WT SJ group using flow cytometry and immunofluorescence assay, and the expression of MerTK and Axl proteins was determined in mouse liver tissues in both groups using Western blotting. In addition, the proportion of MerTK+ macrophages and the average fluorescence intensity of macrophage MerTK were detected in mouse livers in both groups using flow cytometry. Results Data from the GEO database showed that the expression of some efferocytosis receptors and efferocytosis-related bridging molecules, and “eat me” and “don’t eat me” signals all appeared a tendency towards a rise in livers of patients and mice in the SJ group relative to the NC group, suggesting that S. japonicum infection-induced liver diseases may be associated with efferocytosis. Flow cytometry detected higher proportions of Ly6G+ cells [(13.13 ± 0.45)% vs. (6.48 ± 0.25)%; t = 22.30, P < 0.05] and CD3+ cells [(7.60 ± 0.33)% vs. (3.30 ± 0.42)%; t = 13.98, P < 0.05] in mouse liver macrophages in the SJ group than in the NJ group, and the expression of MerTK protein [(2.30 ± 0.14) vs. (1.14 ± 0.46); t = 4.19, P < 0.05], the mean fluorescence intensity of macrophages [(160.67 ± 15.28) vs. (94.50 ± 19.61); t = 4.81, P < 0.05], and the proportion of MerTK+ macrophages [(20.78 ± 4.17)% vs. (6.85 ± 0.39)%; t = 6.57, P < 0.05] were significantly higher in mouse liver tissues in the SJ group than in the NC group. The Axl expression was lower in mouse liver tissues in the SJ group than in the NC group [(1.25 ± 0.08) vs. (1.93 ± 0.37); t = 2.79, P < 0.05], and the area of granulomas around single eggs [(9.18 ± 1.81) × 104μm2 vs. (5.24 ± 1.35) × 104 μm2; t = 3.03, P < 0.05] and proportion of collagen fibers [(25.27 ± 3.99)% vs. (15.14 ± 4.02)%; t = 3.10, P < 0.05] were significantly greater in livers of S. japonicum-infected mice with injection of efferocytosis inhibitors than in mice without injection of efferocytosis inhibitors. The in vitro efferocytosis efficiency of BMDMs [(32.83 ± 3.17)% vs. (45.43 ± 2.34)%; t = 5.54, P < 0.05], and the proportions of Ly6G+ [(9.37 ± 0.48)% vs. (13.13 ± 0.72)%; t = 7.50, P < 0.05] and CD3+ cells [(4.95 ± 0.17)% vs. (7.64 ± 0.50)%; t = 8.87, P < 0.05] in liver macrophages post-infection with S. japonicum were significantly lower in SR-A CKO mice than in WT mice, and the expression of MerTK protein [(0.65 ± 0.25) vs. (1.96 ± 0.69); t = 3.10, P < 0.05], the average fluorescence intensity of macrophages [(138.33 ± 8.39) vs. (160.67 ± 15.28); t = 3.03, P < 0.05] and the proportion of MerTK+ macrophages [(13.17 ± 5.01)% vs. (22.63 ± 2.06)%; t = 3.56, P < 0.05] were significantly lower in mouse liver tissues in the SR-A CKO SJ group than in the WT group. Western blotting detected no significant difference in the Axl protein expression in mouse liver tissues between the SR-A CKO SJ group and the WT SJ group [(0.48 ± 0.07) vs. (0.68 ± 0.30); t = 1.09, P > 0.05]. There were significant differences in the relative MerTK mRNA and protein expression during efferocytosis of BMDMs among the WT monoculture group, the WT and apoptotic neutrophils co-culture group, the SR-A CKO mono-culture group, and the SR-A CKO and neutrophils co-culture group (F = 9.41 and 40.68, both P values < 0.05). In addition, there was a significant difference in the relative Axl mRNA expression during efferocytosis of BMDMs among the four groups (F = 13.62, P < 0.05); however, no significant difference was seen in the relative Axl protein expression (F = 1.27, P > 0.05). Conclusions Efferocytosis of liver macrophages is seen in mice infected with S. japonicum and inhibits liver fibrosis. SR-A may up-regulate the efficiency of macrophage efferocytosis through regulating the expression of efferocytosis receptors.
4.Effects of different electromagnetic stimulation protocols on hand function and activities of daily living for stroke patients: a network meta-analysis
Shan LIU ; Kunyao XU ; Zhimeng ZHOU ; Lingyun ZHOU ; Mao ZENG ; Sha HE ; Luoyang DAI ; Ting QIN ; Qinglin HU ; Jiahai YANG ; Rui LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(8):916-926
ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.
5.Traditional Chinese Medicine Intervenes in Endoplasmic Reticulum Stress to Treat Diabetic Microvascular Complications:A Review
Zhenlong ZHOU ; Yu DUAN ; Yutian PANG ; Ying JIA ; Mingwei LI ; Hongyu SHA ; Haichun ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):293-305
Diabetic microvascular complications (DMC) are major chronic complications of diabetes,primarily including diabetic kidney disease (DKD),diabetic retinopathy (DR),diabetic cardiomyopathy (DCM),and diabetic peripheral neuropathy (DPN). These complications significantly impact patients' quality of life and prognosis. Modern medicine primarily focuses on symptomatic control in the treatment of DMC,with limited ability to reverse the disease progression. Endoplasmic reticulum stress (ERS),as a central event under hyperglycemic toxicity,is not only a key cause of pancreatic β-cell dysfunction (reduced insulin synthesis and secretion) but also a core driver of damage in various target organs of DMC. It activates three signaling pathways of the unfolded protein response (UPR)-inositol-requiring enzyme 1 (IRE1),activating transcription factor 6 (ATF6),and protein kinase R-like endoplasmic reticulum kinase (PERK),intertwining processes such as autophagy,apoptosis,oxidative stress,and calcium homeostasis imbalance. Traditional Chinese medicine (TCM) offers multi-target and multi-pathway therapeutic advantages and can curb the pathological progression of DMC by regulating ERS. This article systematically reviews the relationships of ERS with pancreatic β-cell function,insulin synthesis,and insulin secretion,and elucidates the core signaling pathways through which ERS mediates DMC. Furthermore,it categorizes and summarizes experimental evidence and mechanisms of single medicinal herbs and their extracts,TCM compound formulas,and modern TCM preparations in regulating ERS for the treatment of various DMC subtypes. Finally,this article proposes ERS as a molecular bridge for integrating traditional Chinese and Western medicine in DMC treatment. Future research should leverage emerging technologies such as network pharmacology,multi-omics analysis,and nano-formulations to establish a synergistic network combining modern hypoglycemic drugs and TCM regulation of ERS. This approach is expected to achieve dual efficacy,enhance drug targeting and bioavailability,deepen the understanding of scientific connotation of TCM,and pave new avenues for the prevention and treatment of DMC.
6.Traditional Chinese Medicine Intervenes in Endoplasmic Reticulum Stress to Treat Diabetic Microvascular Complications:A Review
Zhenlong ZHOU ; Yu DUAN ; Yutian PANG ; Ying JIA ; Mingwei LI ; Hongyu SHA ; Haichun ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):293-305
Diabetic microvascular complications (DMC) are major chronic complications of diabetes,primarily including diabetic kidney disease (DKD),diabetic retinopathy (DR),diabetic cardiomyopathy (DCM),and diabetic peripheral neuropathy (DPN). These complications significantly impact patients' quality of life and prognosis. Modern medicine primarily focuses on symptomatic control in the treatment of DMC,with limited ability to reverse the disease progression. Endoplasmic reticulum stress (ERS),as a central event under hyperglycemic toxicity,is not only a key cause of pancreatic β-cell dysfunction (reduced insulin synthesis and secretion) but also a core driver of damage in various target organs of DMC. It activates three signaling pathways of the unfolded protein response (UPR)-inositol-requiring enzyme 1 (IRE1),activating transcription factor 6 (ATF6),and protein kinase R-like endoplasmic reticulum kinase (PERK),intertwining processes such as autophagy,apoptosis,oxidative stress,and calcium homeostasis imbalance. Traditional Chinese medicine (TCM) offers multi-target and multi-pathway therapeutic advantages and can curb the pathological progression of DMC by regulating ERS. This article systematically reviews the relationships of ERS with pancreatic β-cell function,insulin synthesis,and insulin secretion,and elucidates the core signaling pathways through which ERS mediates DMC. Furthermore,it categorizes and summarizes experimental evidence and mechanisms of single medicinal herbs and their extracts,TCM compound formulas,and modern TCM preparations in regulating ERS for the treatment of various DMC subtypes. Finally,this article proposes ERS as a molecular bridge for integrating traditional Chinese and Western medicine in DMC treatment. Future research should leverage emerging technologies such as network pharmacology,multi-omics analysis,and nano-formulations to establish a synergistic network combining modern hypoglycemic drugs and TCM regulation of ERS. This approach is expected to achieve dual efficacy,enhance drug targeting and bioavailability,deepen the understanding of scientific connotation of TCM,and pave new avenues for the prevention and treatment of DMC.
7.Traditional Chinese Medicine Treats Coronary Heart Disease by Intervening in Cardiovascular Cell Apoptosis: A Review
Zhenlong ZHOU ; Yu DUAN ; Hongyu SHA ; Haichun ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):289-298
Coronary heart disease (CHD), as a globally prevalent disease with high mortality, is closely associated with cardiovascular cell apoptosis in its pathogenesis. Although current therapies such as percutaneous coronary intervention (PCI) can alleviate local stenosis and significantly improve revascularization, challenges such as postoperative reperfusion injury and microcirculation dysfunction persist. Due to the limitations of single-target therapy in modern medicine, traditional Chinese medicine (TCM) has attracted increasing attention for its multi-component and multi-target interventions. Modern medical research indicates that cardiovascular cell apoptosis contributes to CHD progression through multiple pathways, including the mitochondrial pathway, death receptor pathway, and endoplasmic reticulum stress pathway. In TCM theory, CHD falls under the categories of chest obstruction, heart pain, and real heart pain. The Synopsis of the Golden Chamber (Jin Gui Yao Lue) proposes the pathogenesis theory of Yang deficiency and Yin excess, emphasizing the therapeutic principles of activating blood, regulating Qi movement, resolving stasis, and unblocking collaterals. TCM demonstrates unique advantages in ameliorating myocardial ischemia and combating atherosclerosis. However, existing studies are largely confined to clinical observations, lacking in-depth exploration of TCM mechanisms in inhibiting cardiovascular cell apoptosis. This article systematically reviews the regulatory mechanisms of cardiovascular cell apoptosis in CHD and TCM intervention strategies, aiming to provide a theoretical basis for elucidating the scientific rationale behind TCM's role in suppressing apoptosis and improving cardiac function, while offering insights for developing innovative treatment approaches combining TCM and modern medicine. Future studies should leverage modern molecular biological technologies to further uncover the scientific essence of TCM regulation of apoptotic pathways. Integrating TCM's holistic regulation and multi-target intervention strengths with modern medicine's targeted therapies can advance both fundamental research and clinical translation, ultimately providing superior strategies for the prevention and treatment of CHD.
8.Multidimensional Analysis of Mechanisms of Nuciferine Against Cerebral Ischemia Based on Transcriptomic Data
Yingying QIN ; Peng LI ; Sha CHEN ; Yan LIU ; Jintang CHENG ; Qingxia XU ; Guohua WANG ; Jing ZHOU ; An LIU ; Chang CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):184-191
ObjectiveStudies have shown that nuciferine has anti-cerebral ischemia effect, but the specific mechanism of action has not been elaborated. Based on the transcriptome results, the pharmacological mechanism of nuciferine against cerebral ischemia was analyzed from multiple dimensions including tissue, cell, pathological process, biological process and signaling pathway. MethodsThirty SD rats were randomly divided into the sham group, model group and nuciferine group(40 mg·kg-1) according to weight. Except for the sham group, the model of middle cerebral artery occlusion(MCAO) was established by thread embolization method after 30 min of administration in the other two groups. Twenty-four hours after surgery, transcriptome sequencing was used to detect the gene expression profiles in the cortex penumbra of rat cerebral tissue, and gene ontology(GO) and kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis were performed for differentially expressed genes. The mechanismof nuciferine against cerebral ischemia was analyzed from 5 dimensions of tissue, cell, pathological process, biological process and signaling pathway by the transcriptome-based multi-scale network pharmacology platform(TMNP). ResultsTranscriptome sequencing and gene quantitative analysis showed that 667 genes were significantly reversed by nuciferine. Further enrichment analysis of KEGG and GO suggested that the pathways of nuciferine involved regulating stress response, ion transport, cell proliferation and differentiation, and synaptic function. TMNP research found that at the tissue level, nuciferine could significantly improve the cerebral tissue injury caused by ischemia. At the cellular and pathological levels, nuciferine could play an anti-cerebral ischemia role by improving the state of various nerve cells, mobilizing immune cells, regulating inflammation. And at the level of biological processes and signaling pathways, nuciferine mainly acted on the processes such as vascular remodeling, inflammation-related signaling pathways, and synaptic signaling. ConclusionCombined with the results of transcriptome sequencing, gene quantitative analysis and TMNP, the mechanism of nuciferine against cerebral ischemia may be related to processes such as intervening in stress response and inflammation, affecting vascular remodeling and regulating synaptic function. These results can provide a basis and reference for further study of the pharmacological mechanism of nuciferine against cerebral ischemia.
9.Experiences of food avoidance behavior in patients with inflammatory bowel disease:a qualitative study
Qingyu WANG ; Meijing ZHOU ; Yang LEI ; Sha LI ; Junyi GU ; Zheng LIN ; Qiugui BIAN ; Jiefeng YANG ; Lichen TANG ; Jiali CHEN ; Hantian CHENG
Chinese Journal of Nursing 2025;60(11):1323-1329
Objective This study applies Roy adaptation theory to deeply explore the experience of food avoid-ance behavior in patients with inflammatory bowel disease(IBD),offering insights for developing dietary management strategies.Methods A descriptive qualitative research method was employed.By purposive sampling,24 IBD pa-tients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews.Data were analyzed using a directed content analysis approach.Results This study identified 4 main themes and 11 sub-themes,encompassing overattribution leading to inappro-priate avoidance(recurrent symptoms triggering overattribution,disease staging triggering inappropriate avoidance),negative self-perception leading management struggles(illness fear diminishing self-efficacy,disease trauma eroding self-identity,knowledge deficiency constraining self-determination),functional impairment intensifying role challenges(role internalization undermining social function,social roles relinquishing dietary management),and external con-straints amplifying practical difficulties(family and friend oversight heightening dietary stress,healthcare gaps foster-ing practical helplessness,traditional beliefs restricting dietary exploration,economic hardship limiting balanced nu-trition).Conclusion The interplay of overattribution,negative self-perception,functional impairment,and external constraints in IBD patients hinders their ability to adapt to disease fluctuations,ensnaring them in the adaptive predicament of food avoidance behavior.Healthcare professionals should comprehensively address these factors by fostering accurate perceptions,enhancing psychological support,guiding effective coping strategies,and optimizing ex-ternal resources,thereby improving patients' overall adaptive capacity and promoting their recovery.
10.Application and safety analysis of cardiopulmonary bypass precharge with 4% succinylated gelatin during surgery for children with cyanotic congenital heart disease
Sha WANG ; Huijun WANG ; Shuo PAN ; Baoguo SONG ; Wei XU ; Gang ZHOU ; Wei HUANG
Clinical Medicine of China 2025;41(3):207-213
Objective:To investigate the application and safety of cardiopulmonary bypass precharge with 4% succinylated gelatin during surgery for children with cyanotic congenital heart disease (CCHD).Methods:A prospective case-control study was conducted. One hundred and thirty children with CCHD undergoing cardiac surgery admitted to Shaanxi Provincial People's Hospital in 2021-2024 were selected as study participants. Participants were divided into control group ( n=65) and gelatin group ( n=65) by random number table method based on the principle of matching baseline characteristics between groups. Children in the control group were pre-filled with 10-20 ml/kg of fresh frozen plasma, while the gelatin group was pre-filled with 10-20 ml/kg of 4% succinyl gelatin. Thrombelastogram parameters [fibrin formation time, blood clot strength, fibrinogen maximum amplitude, fibrinogen content], hematological parameters [platelet count, prothrombin time (PT), prothrombin activity (PTA), hemoglobin], myocardial function [troponin, creatine kinase, creatine kinase isoenzyme (CK-MB)] and liver-kidney function were compared before and after treatment.Measurement data with normal distribution was expressed as " xˉ±s", independent sample t-test was used on comparison between groups, paired t-test was used for intra-group comparisons before and after treatment. Counting data was expressed as rate or composition ratio, χ2 test was used on comparison between groups. Results:Comparison between groups showed that before treatment, the difference of various thromboelastography parameters, haematological parameters, myocardial function indexes, liver and kidney function indexes were not statistically significant ( P>0.05). Compared to before treatment, R, PTA, troponin and creatine kinase increased in both groups after treatment [control group:(51±4) s vs. (43±3) s, (98±15)% vs. (95±12)%, (0.624±0.085) μg/L vs. (0.040±0.005) μg/L, (711±50) U/L vs. (96±11) U/L, (60±7) U/L vs. (22±4) U/L, t values were -17.92、-2.13、-104.63、-165.15、-57.43, respectively, all P<0.001; gelatin group: (51±4) s vs. (42±3) s, (100±16)% vs. (94±13)%, (0.631±0.113) μg/L vs. (0.041±0.004) μg/L, (717±52) U/L vs.(97±11) U/L, (62±7) U/L vs.(24±4) U/L, t values were -19.79、-3.09、-81.31、-157.70、-54.67, respectively, all P<0.001], while MA, MAf, FLEV, platelet count, PT and hemoglobin decreased [control group: (50±4) mmHg vs. (57±5) mmHg、(5.5±0.9) mmHg vs. (13.8±1.3) mmHg、(1.58±0.22) g/L vs.(2.64±0.31) g/L、(217±21)×10 9/L vs. (275±25)×10 9/L、(13.3±0.5) s vs.(14.7±0.8) s、(116±12) g/L vs.(127±17) g/L, t values were 14.79、61.26、32.25、20.58、17.21、6.09,respectively, all P<0.001; gelato group: (49±3) mmHg vs. (57±5) mmHg、(5.7±0.8) mmHg vs. (14.0±1.4) mmHg、(1.62±0.27) g/L vs.(2.59±0.26) g/L、(214±20)×10 9/L vs.(273±23)×10 9/L、(13.4±0.5) s vs.(14.7±0.8) s、(114±12) g/L vs.(128±17) g/L, t values were 16.34、62.05、29.51、22.77、14.91、7.41, respectively, all P<0.001], but the differences between groups were not statistically significant (all P>0.05). The difference of albumin, alanine aminotransferase, aspartate aminotransferase and creatinine before and after treatment were not statistically significant (all P>0.05). Conclusion:4% succinylated gelatin does not increase the risk of coagulation dysfunction during perioperative period in children with CCHD. It has small influence on liver-kidney function and has high safety.

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