1.Syndrome Differentiation and Treatment of Asymptomatic Renal Hematuria Population Based on Association of Age-Constitution-Syndrome
Guangjian WANG ; Cong QIN ; Yibo WU ; Guodong YUAN ; Suzhi CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):247-255
For a long time, simple asymptomatic renal hematuria has not been taken seriously. Current studies have confirmed that renal hematuria is a risk factor for the progression of renal function, but there is no effective treatment available. Because asymptomatic renal hematuria is highly concealed and lacks typical symptoms, individualized syndrome differentiation in traditional Chinese medicine (TCM) is difficult, making it a challenge in clinical diagnosis and treatment. Although TCM has a long history and solid theoretical basis in the treatment of hematuria, it urgently needs to break through the bottleneck of traditional syndrome differentiation. Based on classical TCM theories, research achievements in modern constitution studies, and relevant clinical and pathological evidence, this article focuses on the decisive influence of age on constitution distribution and its regular association with the evolution of core syndromes, and constructs a three-dimensional diagnostic and therapeutic system of "age-constitution-syndrome". It reveals that the syndrome manifestations of asymptomatic renal hematuria are profoundly shaped by constitution, and that constitution shows a group distribution pattern with age-children often present with deficiency of lung and spleen Qi combined with wind-heat, young and middle-aged individuals often present with deficiency of liver and kidney Yin combined with deficient fire and stasis heat, and elderly individuals often present with deficiency of spleen and kidney combined with cold-dampness and stasis obstruction. By analyzing the common pathogenic mechanisms, outcome characteristics, and internal mechanisms among different age groups, this study provides a basic syndrome framework and core intervention strategies for specific populations in clinical practice, offering a new evidence-based approach to addressing the dilemma of “no identifiable syndrome”.
2.Evaluation system for standardized surgery in elderly patients with lung cancer
Xingqi MI ; Nan CHEN ; Jiandong MEI ; Hecheng LI ; Shuguang ZHANG ; Huanwen CHEN ; Peng JIAO ; Jun WANG ; Chunfang ZHANG ; Guangjian ZHANG ; Xin LI ; Qiang PU ; Peng LIN ; Lunxu LIU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):866-873
To address the growing challenge of an increasing number of elderly lung cancer patients amidst China's aging population and to fill the gap in quality control standards for surgical treatment in this special population, this study aimed to develop a standardized surgical evaluation system for elderly lung cancer patients tailored to China's national conditions. The system was established through a literature review, integrated the pathophysiological characteristics of elderly patients, and was constructed following review, feedback, and revision by experts from multiple thoracic surgery centers. Employing a 100-point scoring system, it comprises three primary domains: physical infrastructure and geriatric adaptability foundational conditions (10 points); management level and perioperative care models (20 points); and technical proficiency and clinical outcomes (70 points). The system places a strong emphasis on geriatric adaptability, proposing specific, quantifiable indicators for age-friendly facility modifications, control of elderly-specific complications, multidisciplinary collaboration, and standardized perioperative management. It provides a convenient and measurable assessment tool for quality control in the surgical treatment of elderly lung cancer in China, which is expected to promote the standardization and homogenization of diagnosis and treatment.
3.Progress in Disease-Syndrome-Integrated Mouse Models of Lung Cancer
Yulei ZHAO ; Bingbing HAN ; Xingxin WANG ; Guangjian YANG ; Yajie WANG ; Xiaoyong TANG
Laboratory Animal and Comparative Medicine 2026;46(4):531-540
Lung cancer has the highest mortality rate among malignant tumors worldwide, posing a severe threat to human health. Traditional Chinese medicine (TCM) offers unique advantages in treating lung cancer, with disease-syndrome-integrated animal models serving as a critical component of TCM lung cancer research. According to TCM pathogenesis, lung cancer is classified as a pattern of underlying deficiency with superficial excess. Clinically, it is often categorized into syndromes such as qi and yin deficiency, lung-spleen qi deficiency, lung yin deficiency, qi stagnation and blood stasis, and phlegm-heat obstructing the lungs. Treatment should fundamentally adhere to the principle of "strengthening the healthy qi and expelling pathogenic factors". This paper systematically reviews literature from 2005 to 2025 on disease-syndrome-integrated animal models for lung cancer. It summarizes the theoretical basis and establishment methods of four core disease-syndrome-integrated models: qi-yin deficiency pattern, spleen qi deficiency pattern, qi stagnation and blood stasis pattern, and kidney deficiency pattern. Further discussion covers their evaluation systems and limitations. Additionally, modeling approaches for other patterns including yang deficiency, spleen deficiency, and qi deficiency with blood stasis are summarized, with evaluation methods categorized by behavioral characteristics and biochemical indicators. Analysis reveals that current models predominantly use C57BL/6 mice, exhibiting issues such as insufficient clinical relevance, complex modeling procedures, numerous confounding factors, and a low degree of standardization. Future improvements to disease-syndrome-integrated lung cancer animal models could include using clustered regularly interspaced short palindromic repeats (CRISPR) technology to establish organoid–patient-derived xenograft models; developing controllable composite stress systems and standardized stimulus models, such as gradient-controlled alternating cold/heat chambers and programmed dietary regulation systems, to reduce nonspecific interference; and developing multidimensional dynamic modeling techniques by integrating clinical big data, including metabolomics and imaging features, to design dynamic intervention protocols, thereby providing more precise and reliable experimental tools for elucidating the mechanisms of TCM in lung cancer prevention and treatment.
4.Experimental study on the method of establishing a pig left lung orthotopic transplantation model
Heng ZHAO ; Jinteng FENG ; Shan GAO ; Rui ZHAO ; Hongyi WANG ; Ye SUN ; Yixing LI ; Haotian BAI ; Runyi TAO ; Bin HE ; Zhiyu WANG ; Yanpeng ZHANG ; Borui SUN ; Shuo LI ; Guangjian ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(08):1275-1281
Objective To explore the method for establishing a pig left lung orthotopic transplantation model. Methods A total of 4 male Yorkshire pigs weighing (40.0±2.5) kg underwent surgical procedures, including anesthesia, tracheal intubation, donor lung procurement, and recipient lung transplantation. Histological morphology and blood gas analysis of the transplanted lungs were assessed 2 hours after reperfusion to evaluate the histological changes and function of the transplanted lungs. Results The pigs underwent left lung in situ transplantation, effectively simulating conditions relevant to human lung transplantation. Two hours after the transplantation, arterial blood gas analysis showed that arterial partial pressure of oxygen was 155.4-178.6 mm Hg, arterial partial pressure of carbon dioxide was 53.1-62.4 mm Hg, and the oxygenation index was 310.8-357.2 mm Hg. Hematoxylin and eosin staining indicated a low degree of pulmonary edema and minimal cellular infiltration. Conclusion The pig left lung orthotopic transplantation model possesses strong operability and stability. Researchers can replicate this model according to the described methods and further conduct basic research and explore clinical translational applications.
5.Efficacy of near-infrared fluorescence imaging in minimally invasive esophagectomy
Zhuoqi JIA ; Jizhao WANG ; Junke FU ; Guangjian ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(10):1626-1633
Objective To evaluate the short-term outcomes of near-infrared fluorescence imaging (NIRF) technique in minimally invasive McKeown esophagectomy for esophageal cancer. Methods Patients who consecutively underwent minimally invasive McKeown esophagectomy for esophageal cancer performed by a single surgical team in the Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, between July 2020 and December 2023 were included. Patients were categorized into an NIRF group and a control group based on whether NIRF was employed to assess gastric conduit blood flow. We compared the clinical characteristics, operative parameters, major postoperative complications, and short-term quality of life between the two groups. Results A total of 246 patients were included. The NIRF group comprised 132 patients (85 males, 47 females) with a mean age (62.6±6.7) years, and the control group included 114 patients (78 males, 36 females) with a mean age (64.4±3.8) years. There were no significant differences in operative time, intraoperative blood loss, number of harvested lymph nodes, or hospital stay between the two groups (P>0.05). Similarly, the rates of recurrent laryngeal nerve injury or cardiopulmonary complications did not differ significantly between the groups (P>0.05). No chylothorax or 90-day mortality occurred in either group. Anastomotic leakage occurred in 5 (3.79%) patients in the NIRF group and 9 (7.89%) patients in the control group. The difference in anastomotic leakage rates was not statistically significant (P=0.098), showing only a trend towards a lower incidence in the NIRF group. Receiver operating characteristic curve analysis indicated that maximum fluorescence intensity (MFI) was correlated with gastric conduit perfusion, with an MFI of 20.5 identified as the cutoff value for predicting anastomotic leakage (P=0.039). Further analysis showed that in the NIRF group, an indocyanine green fluorescence imaging time >95 s and a blood flow velocity <1.7 cm/s were significantly associated with an increased risk of anastomotic leakage (P<0.05). The SF-36 quality of life score at 3 months postoperatively was significantly better in the NIRF group than in the control group (P<0.001); however, there was no significant difference in scores between the two groups at 12 months postoperatively (P=0.704). Conclusion In minimally invasive esophagectomy for esophageal cancer, NIRF can effectively assess gastric conduit blood perfusion using quantitative parameters, demonstrates a trend towards reducing anastomotic leakage rates, and contributes to accelerated early postoperative recovery and improved short-term quality of life.
6.Application of patient-reported outcome measures in lung transplantation recipients: a systematic review
Jiawei WANG ; Hongyi WANG ; Lei WANG ; Wenjun XU ; Xiao XIAO ; Yumei CHEN ; Yan GUO ; Guangjian ZHANG ; Peng LI
Chinese Journal of Organ Transplantation 2025;46(4):306-316
Objective:To systematically evaluate the application of patient-reported outcome measures (PROMs) in adult lung transplant recipients, and to explore their clinical value in assessing quality of life following transplantation.Methods:This study was a systematic review. Relevant studies published between January 2014 and July 2024 were searched in the PubMed and OVID Medline databases using keywords such as "lung transplantation" "quality of life" "HRQoL" "health indice" "patient-reported outcome measure" "questionnaire" "profile" "scale" "score" and "survey". Only English-language articles were included. Eligible studies were those that applied PROMs to assess quality of life in adult lung transplant recipients and were approved by ethics committees. Reviews, case reports, abstracts, and studies involving transplant candidates or recipients of lung-liver or lung-kidney combined transplantation were excluded. Data extracted included basic study information, study design, participant characteristics, and PROM usage. Frequently used PROMs and lung transplant-specific PROMs were summarized, and results with clearly reported time points were analyzed.Results:A total of 63 studies were included, comprising 54 (85.7%) observational studies and 9 (14.3%) interventional studies. The majority of studies originated from the United States (18 studies, 28.6%). A total of 55 different PROMs were identified, including 30 generic and 25 disease-specific instruments. The five most frequently used PROMs were the Short Form 36 (SF-36; 30 studies, 47.6%), the EuroQol 5 Dimension (EQ-5D; 12 studies, 19.0%), the St. George's Respiratory Questionnaire (SGRQ; 11 studies, 17.5%), the Hospital Anxiety and Depression Scale (HADS; 7 studies, 11.1%), and the modified Medical Research Council dyspnea scale (mMRC; 5 studies, 7.9%). Lung transplant-specific PROMs included the Lung Transplant Quality of Life questionnaire (LT-QOL), the Lung Transplant Valued Life Activities (LT-VLA) scale, and the Pulmonary-Specific Quality of Life Scale (PQLS), which were applied in only 6 studies (9.5%). Across studies, lung transplantation was associated with significant improvements in recipients' quality of life, sustained over a follow-up period of 3 to 60 months.Conclusions:A wide range of PROMs have been employed to assess health-related quality of life in lung transplant recipients; however, transplant-specific PROMs remain relatively scarce. PROMs provide valuable insights for reflecting and dynamically monitoring long-term quality of life, supplementing evidence for clinical decision-making, and optimizing post-transplant care strategies.
7.Application of patient-reported outcome measures in lung transplantation recipients: a systematic review
Jiawei WANG ; Hongyi WANG ; Lei WANG ; Wenjun XU ; Xiao XIAO ; Yumei CHEN ; Yan GUO ; Guangjian ZHANG ; Peng LI
Chinese Journal of Organ Transplantation 2025;46(4):306-316
Objective:To systematically evaluate the application of patient-reported outcome measures (PROMs) in adult lung transplant recipients, and to explore their clinical value in assessing quality of life following transplantation.Methods:This study was a systematic review. Relevant studies published between January 2014 and July 2024 were searched in the PubMed and OVID Medline databases using keywords such as "lung transplantation" "quality of life" "HRQoL" "health indice" "patient-reported outcome measure" "questionnaire" "profile" "scale" "score" and "survey". Only English-language articles were included. Eligible studies were those that applied PROMs to assess quality of life in adult lung transplant recipients and were approved by ethics committees. Reviews, case reports, abstracts, and studies involving transplant candidates or recipients of lung-liver or lung-kidney combined transplantation were excluded. Data extracted included basic study information, study design, participant characteristics, and PROM usage. Frequently used PROMs and lung transplant-specific PROMs were summarized, and results with clearly reported time points were analyzed.Results:A total of 63 studies were included, comprising 54 (85.7%) observational studies and 9 (14.3%) interventional studies. The majority of studies originated from the United States (18 studies, 28.6%). A total of 55 different PROMs were identified, including 30 generic and 25 disease-specific instruments. The five most frequently used PROMs were the Short Form 36 (SF-36; 30 studies, 47.6%), the EuroQol 5 Dimension (EQ-5D; 12 studies, 19.0%), the St. George's Respiratory Questionnaire (SGRQ; 11 studies, 17.5%), the Hospital Anxiety and Depression Scale (HADS; 7 studies, 11.1%), and the modified Medical Research Council dyspnea scale (mMRC; 5 studies, 7.9%). Lung transplant-specific PROMs included the Lung Transplant Quality of Life questionnaire (LT-QOL), the Lung Transplant Valued Life Activities (LT-VLA) scale, and the Pulmonary-Specific Quality of Life Scale (PQLS), which were applied in only 6 studies (9.5%). Across studies, lung transplantation was associated with significant improvements in recipients' quality of life, sustained over a follow-up period of 3 to 60 months.Conclusions:A wide range of PROMs have been employed to assess health-related quality of life in lung transplant recipients; however, transplant-specific PROMs remain relatively scarce. PROMs provide valuable insights for reflecting and dynamically monitoring long-term quality of life, supplementing evidence for clinical decision-making, and optimizing post-transplant care strategies.
8.Screening and Identification of the Shared Differentially Expressed Genes in Systemic Lupus Erythematosus and Sjogren's Syndrome Based on GEO Database
Wentao GUO ; Zhaowei GAO ; Yan LIU ; Li LIU ; Xi WANG ; Guangjian LU ; Luyang JIAO
Journal of Modern Laboratory Medicine 2025;40(1):38-42,58
Objective To explore the potential pathogenesis of SLE and SS based on GEO database with screening differential expression genes common in systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS),analyzing their functions and identifing their expression levels. Methods The gene expression datasets of SLE and SS whole blood samples were retrieved from GEO database. Differential expression genes in peripheral blood cells of SLE and SS were screened using gene expression datasets GSE50772,GSE81622,GSE84844 and GSE48378,respectively,and the shared differential expression genes of SLE and SS were screened. Functional analysis of differentially expressed genes was performed using Gene Ontology (GO) analysis and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Peripheral blood from SLE and SS patients and healthy controls were collected from March 2024 to April 2024,recruited from the Second Affiliated Hospital of Air Force Medical University. Quantitative fluorescence real-time PCR (qRT-PCR) was used to identify the expression levels of 11 genes with the most significant differences in expression. Results 232 and 110 differentially expressed genes were screened for SLE and SS,respectively,among which 32 genes shared by SLE and SS were up-regulated in expression levels. Functional analysis showed that the 32 differentially expressed genes were mainly enriched in biological processes related to interferon (IFN) signaling pathways,defense response to viruses,response to viruses,negative regulation of viral genome replication,and immune response. KEGG pathway analysis showed that 32 differentialy expressed genes were associated with the process of viral infection. The clinical sample identification results showed that the expression levels of OAS3,IFI44,IFI44L and EPSTI1 were significantly elevated in PBMC of SLE and SS patients. Conclusion This study suggested that changes in biological processes related to IFN signal and viral infection response play important roles in both SLE and SS development,and may be a predisposing factor and potential biomarker for SLE and SS.
9.Association Between Neutrophil to High-density Lipoprotein Cholesterol Ratio and Incidence of Cardiovascular Disease in Patients With Metabolic Associated Fatty Liver Disease
Guizhong FANG ; Lin WEN ; Xinyu WANG ; Shuting FENG ; Ying ZHOU ; Shuohua CHEN ; Guangjian LI ; Xiaozhong JIANG ; Shouling WU ; Shan WANG
Chinese Circulation Journal 2025;40(6):605-610
Objectives:This study aims to investigate the relationship between neutrophil to high-density lipoprotein cholesterol ratio(NHR)and incidence of cardiovascular disease(CVD)among individuals with metabolic associated fatty liver disease(MAFLD).Methods:We conducted a prospective cohort study utilizing health check-up data from 2006 to 2007 at Kailuan General Hospital and its 10 affiliated hospitals.The study population consisted of employees and retirees diagnosed with MAFLD,excluding those with incomplete neutrophil and high-density lipoprotein cholesterol data or a history of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.CVD was defined as the presence of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.Annual follow-ups were conducted from 2006,new-onset CVD cases identified through discharge records from the 11 Kailuan Group hospitals and records from municipal social insurance agencies,the final follow up date was December 31,2022.NHR was calculated as the ratio of neutrophil to high-density lipoprotein cholesterol,and the MAFLD cohort(n=28 952)was stratified into four groups by NHR quartiles:Q1 group(NHR<1.97,n=7 241),Q2 group(1.97≤NHR<2.57,n=7 235),Q3 group(2.57≤NHR<3.36,n=7 240),and Q4 group(NHR≥3.36,n=7 236).The Kaplan-Meier method was employed to plot survival curves for new-onset CVD,and the cumulative incidences of CVD across different NHR quartiles groups were determined.Intergroup comparisons were made using the log-rank test,and a multifactorial Cox proportional hazards regression model was used to assess the association between NHR quartiles and the risk of new-onset CVD in the MAFLD population.Results:The average follow-up duration was(14.03±3.99)years,during which 4 666 new CVD cases were recorded among the study population.The number of CVD cases across Q1 group to Q4 group were 1 061,1 167,1 186 and 1 252,respectively,with an overall incidence density of 11.5 cases per 1 000 person-years.The incidence densities for Q1 group to Q4 group were 10.4,11.4,11.7 and 12.5 cases per 1 000 person-years,respectively.The multifactorial Cox proportional hazards regression analysis revealed that higher NHR quartiles were associated with an increased relative risk of new-onset CVD(Q2 group:HR=1.13,95%CI:1.04-1.23;Q3 group:HR=1.15,95%CI:1.05-1.25;Q4 group:HR=1.22,95%CI:1.12-1.33).Conclusions:The risk of new-onset cardiovascular disease in individuals with MAFLD escalates with increasing NHR.
10.Collection, storage and utilization of lung transplant tissue samples
Yixing LI ; Xue SHI ; Hongyi WANG ; Runyi TAO ; Ye SUN ; Ailing SU ; Liyan TONG ; Jinteng FENG ; Yanpeng ZHANG ; Shuo LI ; Yawen WANG ; Guangjian ZHANG
Organ Transplantation 2025;16(1):147-155
After continuous development and improvement, lung transplantation has become the preferred means to treat a variety of benign end-stage lung diseases. However, the field of lung transplantation still faces many challenges, including shortage of donor resources, preservation and maintenance of donor lungs, and postoperative complications. Lung tissue samples removed after lung transplantation are excellent clinical resources for the study of benign end-stage lung disease and perioperative complications of lung transplantation. However, at present, the collection, storage and utilization of tissue samples after lung transplantation are limited to a single study, and unified technical specifications have not been formed. Based on the construction plan of the biobank for lung transplantation in the First Affiliated Hospital of Xi'an Jiaotong University, this study reviewed the practical experience in the collection, storage and utilization of lung transplant tissue samples in the aspects of ethical review, staffing, collection process, storage method, quality control and efficient utilization, in order to provide references for lung transplant related research.

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