1.Research on The Genealogical Inference Efficiency of High-density SNPs
Jing LI ; Yi-Jie SUN ; Wen-Ting ZHAO ; Zi-Chen TANG ; Jing LIU ; Cai-Xia LI
Progress in Biochemistry and Biophysics 2026;53(3):740-753
ObjectiveThis study aims to explore the potential of different orders of magnitude single-nucleotide polymorphism (SNP) locus combinations for predicting distant kinship relationships. A high-density SNP locus set was constructed, and a comprehensive assessment of its inference capability was conducted. MethodsFirstly, we selected three commercial chip panels, CGA (Chinese genotyping array, Illumina), GSA (Global screening array, Illumina), Affy (23MF_V2 high-density SNP array, Affymetrix) and merged them after quality control, forming a high-density SNP locus panel(1 180 k). Secondly, we selected 161 samples and collected their peripheral blood samples by using whole-genome sequencing technology. Within this sample population, the levels of kinship relationships fully covered the range from level 1 to level 9, and the number of kinship pairs at each level was consistently maintained at over 50 pairs. From 161 samples data of whole-genome sequencing, the 1 180 k locus set was extracted, which is referred to as the high-density SNP locus set in the following text. The kinship inference was conducted using the identity-by-descent (IBD) algorithm with the selected optimal parameters. To comprehensively evaluate the performance of the high-density SNP locus set in kinship inference, we compared it with the three commercial chip panels, the intersection of these three chip loci, and the control sets constructed by randomly reducing the number of the high-density SNP locus set. Based on the changes in the IBD lengths, as well as the dynamic trends in prediction accuracy, we conducted a scientific assessment of the kinship inference capability of the high-density SNP locus set. ResultsAfter screening, a set of 1 184 334 autosomal SNPs was obtained. During the process of screening the optimal IBD length threshold, the result revealed that 0 cM, 1 cM, and 2 cM all demonstrated good applicability. However, to avoid the issue of a large amount of redundant information caused by setting a too low IBD length threshold, this study ultimately selected 2 cM as the optimal threshold. Compared with the average results of three chip panels, the high-density SNP locus set increased the total IBD length and the average IBD length across levels 1-9; the accuracy of the confidence interval for level 8 was 70.97%, which represented a 3.50% improvement; the average confidence interval accuracy for levels 1-8 was 91.39%, representing a 1.00% increase; and the false negative rates at levels 8 and 9 were reduced by 2.42% and 6.76%, respectively. The system efficacy of the high-density SNP locus set for kinship inference of first to eighth degree relationships reached 98.91%. Through random reduction of the high-density SNP locus set results, it is found that increasing the number of SNPs with the panel, the detection efficiency of IBD length showed a significant upward trend. At the same time, the overall trend in the accuracy of kinship relationship prediction as well as the confidence interval accuracy also indicated that both metrics steadily increased with the addition of more loci. ConclusionThe results show that the high-density SNPs panel significantly enhances the efficacy of distant kinship inference, accurately covering kinship degrees, with the average confidence interval accuracy for first to eighth degree relationships stably above 90%. The study finds that increasing the number of SNPs panel can improve the ability to predict distant kinship.
2.Association Between MTHFR C677T Gene Polymorphism and Hypertension, Hyperhomocysteinemia and Hyperlipidemia in Tibet Region
Pengchang LI ; Danni MU ; Zhijuan LIU ; Xiaoxing LIU ; Puchi ZEJI ; Liping TIAN ; Honglei LI ; Li'an HOU ; Dandan LI ; Jie WU ; Ling QIU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):280-285
To explore the correlation between MTHFR C677T gene polymorphism and hypertension, hyperhomocysteinemia(Hcy), and hyperlipidemia in the Tibetan population of Tibet. Using a cluster sampling method, participants from high-altitude regions including Ngari Prefecture, Lhasa City, and Nyingchi City in Tibet were enrolled. Differences in MTHFR C677T genotype distribution among individuals with hypertension, HHcy, and hyperlipidemia were analyzed, and multivariate logistic regression was performed to assess the association between these conditions and the TT genotype. A total of 574 eligible subjects were included, with a mean age of 40.64±12.67 years. Males accounted for 46.7%(268/574) and females 53.3%(306/574). Regional distribution was 34.8%(200/574) from Nyingchi City, 33.1%(190/574) from Lhasa City, and 32.1%(184/574) from Ngari Prefecture. Mean systolic and diastolic blood pressures were 117.89±18.98 mm Hg and 79.74±14.88 mm Hg, respectively. The frequency of the TT genotype was significantly higher in the hypertension group than in the non-hypertension group(12.32% The MTHFR C677T TT genotype is significantly associated with hypertension and hyperhomocysteinemia in the Tibetan population, suggesting that this polymorphism may be a genetic risk factor for these diseases in high-altitude regions.
3.Analysis on Construction of Whole-course Management Model for Panvascular Diseases
Shuyuan LIU ; Jie WANG ; Jun LI ; Xingjiang XIONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):12-22
Panvascular diseases are systemic diseases with atherosclerosis as the pathological core, involving multiple vascular beds and target organs throughout the body. Due to their wide range and complexity, the traditional single-discipline prevention and treatment model struggles to meet the needs of systematic management, while clinical diagnosis often remains one-sided and insufficient, leading to delayed treatment. Literature reviews show that panvascular diseases involve a wide range of lesion sites, numerous influencing factors, and are prone to endangering life and health. It is urgent to construct a comprehensive and whole-course prevention and treatment management system, with vascular health as the goal and patients as the core. First, early screening and risk assessment should be conducted for high-risk groups. In terms of treatment decisions for patients, multi-disciplinary collaboration is needed to establish a scientific and standardized prevention and treatment path. Second, it is important to attach great importance to a people-centered approach, enhance patients' familiarity with the disease through cognitive intervention, and shift from passive treatment to active health care. Thirdly, it is needed to leverage the advantages of modern science and technology, promote the deep integration of artificial intelligence innovations and modern medicine, and help traditional diagnosis and treatment plans evolve towards precision, intelligence, and personalization. This will open up new paths for the modernization of the whole-course management of pan-vascular diseases. Fourth, efforts should be made to continue to carry forward and innovate the characteristics of traditional Chinese medicine, adhere to equal emphasis on modern and traditional medicine, promote complementary advantages and coordinated development of Chinese and Western medicine, and form a unique Chinese model for the whole-course management of panvascular diseases. Fifth, through the reintegration and redistribution of government, medical insurance, and medical resources, comprehensive talents in the broad vascular disciplines should be cultivated and an efficient hierarchical management model established, providing reference and guidance for the whole-course management of comprehensive diseases in the future.
4.Exploration in Relationship Between Mitochondrial Homeostasis Dysregulation and Panvascular Diseases Based on Theory of ''Positive Deficiency Phlegm Stasis''
Hongping LI ; Jie WANG ; Zhenpeng ZHANG ; Chao LIU ; Lanchun LIU ; Chengzhi HOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):30-38
Panvascular diseases represent systemic vascular disorders characterized by atherosclerosis as their core pathological feature. Their incidence rates continue to rise, posing significant challenges for clinical management. Based on Traditional Chinese Medicine (TCM) theory of ''positive deficiency phlegm stasis'', this study delved into the pivotal role of mitochondrial homeostasis dysregulation in the pathogenesis and progression of pan-vascular diseases, along with its intrinsic connection to TCM pathogenesis. Mitochondrial homeostasis dysregulation pervades the entire course of these diseases, with mitochondrial oxidative stress serving as the initiating factor. Excessive reactive oxygen species (ROS) trigger endothelial dysfunction, lipid accumulation, and inflammatory initiation. Additionally, the imbalance between mitochondrial autophagy and apoptosis constitutes a pivotal link in disease progression. Excessive or insufficient autophagy may lead to the accumulation of damaged mitochondria and excessive cellular apoptosis, thereby promoting plaque instability. Furthermore, mitochondrial metabolic reprogramming impairs energy supply and function in vascular wall cells, hindering subsequent vascular repair. These pathological processes constitute the microscopic manifestation of the core pathogenesis, which is characterized by ''the intermingle of phlegm and stasis and the deficiency of healthy Qi''. Specifically, the endogenous phlegm-turbidity drives mitochondrial oxidative stress injuries, the mutual entanglement of phlegm and stasis induces an imbalance between mitochondrial autophagy and apoptosis, while deficiency of healthy Qi propels mitochondrial energy metabolism disorders and reprogramming. In view of this, this study proposed to employ phlegm-resolving and turbidity-clearing methods to mitigate mitochondrial oxidative stress injuries, phlegm-resolving and blood-activating methods to regulate mitochondrial autophagy and apoptosis, and spleen-tonifying and kidney-nourishing methods to modulate mitochondrial metabolic reprogramming. This approach can prevent and treat panvascular diseases by multi-target regulation of mitochondrial homeostasis, providing a theoretical framework and therapeutic strategies for the prevention and treatment of panvascular diseases through integrated Chinese and Western medicine.
5.Investigating Effect of Xianglian Huazhuo Prescription on Cell Cycle and Proliferation in Rats with Chronic Atrophic Gastritis Through TGF-β1/Smads Signaling Pathway
Yican WANG ; Jie WANG ; Yirui CHENG ; Xiaojing LI ; Yibin MA ; Qiuhua LIU ; Ziwei LIU ; Yuxi GUO ; Pengli DU ; Yanru CAI ; Yao DU ; Zheng ZHI ; Bolin LI ; Qian YANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):128-136
ObjectiveTo explore the potential mechanism of Xianglian Huazhuo prescription (XLHZ) in treating chronic atrophic gastritis (CAG) by regulating cell cycle and inhibiting proliferation, using bioinformatics technology and animal experiments. MethodsDifferential expressed genes (DEGs) related to CAG were screened using GEO database and GEO2R tool. Weighted gene co-expression network analysis (WGCNA) was employed to search for hub genes of CAG. These hub genes were intersected with cell cycle proliferation based on GeneCards database. Eenrichment analysis of the intersecting genes was performed to obtain signaling pathways and biological processes related to CAG. Protein protein interaction (PPI) analysis of genes was conducted using the Protein Interaction Platform (STRING) database to search the super hub gene (hub 2.0), and animal experiments were conducted for further validation. Fourteen of 70 male Wistar rats were randomly selected as the normal group, and the remaining 56 rats were prepared by the combined modeling method of "starvation disorder+N-methyl-N-nitro-N-nitrosoguanidine (MNNG) + sodium salicylate". The successfully modeled rats were randomly divided into the model group, XLHZ-H, XLHZ-M, and XLHZ-L groups (36, 18, 9 g·kg-1, respectively), and Morodan group (1.4 g·kg-1). Each group was given corresponding intervention for 60 days. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of gastric mucosa in rats. The ultrastructure of gastric mucosal tissue cells was observed by transmission electron microscopy. The relative expression levels of TGF-β1, Smad2 and Smad3 proteins, S/G2/M phase marker geminin and proliferation marker MCM2 were detected by Western blot in gastric mucosal tissue, and Spearman correlation analysis was performed. ResultsA total of 15 hub 2.0 genes were identified, including TGF-β1, suggesting the involvement of the TGF-β1 signaling pathway in the CAG pathogenesis. Compared with the normal group, the expressions of TGF-β1, Smad2, geminin and MCM2 proteins in the gastric mucosa tissue of the model group were increased (P<0.05), and the expression of Smad3 protein was decreased (P<0.05). Compared with the model group, the expressions of TGF-β1 and geminin in the gastric mucosa were decreased in the drug groups (P<0.05). The XLHZ-M group, XLHZ-H group and Morodan group had significantly decreased protein expression of Smad2 and MCM2 (P<0.05). The protein expression of Smad3 was significantly increased in XLHZ-M, XLHZ-H, and Morodan groups (P<0.05). Spearman correlation analysis showed that Smad3 was negatively correlated with other indicators, and positively correlated with other indicators (P<0.01). ConclusionXLHZ may inhibit TGF-β1/Smads signaling pathway, regulate cell cycle, and inhibit proliferation in the treatment of CAG.
6.Evaluation of photoreceptor cell lesions in age-related macular degeneration patients by adaptive optics scanning laser ophthalmoscope
Yuanrui SUN ; Cheng LI ; Jie XU ; Xue LI ; Wei LIU
International Eye Science 2026;26(4):674-682
AIM:To observe the morphological and structural changes of foveal cone photoreceptors in patients with age-related macular degeneration(ARMD)using adaptive optics scanning laser ophthalmoscopy(AOSLO)and to evaluate its application value in ARMD.METHODS:This was a retrospective cross-sectional study. Patients with ARMD who visited the Department of Ophthalmology, Army Medical Center of PLA, Army Medical University, and underwent AOSLO examination between September 2025 and October 2025 were enrolled as the experimental group(ARMD group). Age-matched individuals who underwent AOSLO examination during the same period and had either age-related cataract or pseudophakia with a normal macular region were selected as the control group(CON group). The AOSLO device was used to image a 2.4°×2.4° area of the fovea, and parameters including parafoveal cone photoreceptor density(PCPD), average inter-cell spacing, cell dispersion, and cell regularity were analyzed.RESULTS:A total of 53 participants(66 eyes)were included, comprising 24 patients(33 eyes)in the ARMD group [comprising 6 participants(6 eyes)in the intermediate ARMD group and 22 participants(27 eyes)in the late ARMD group(4 participants had one eye in the intermediate group and the other in the late ARMD group)], and 29 participants(33 eyes)in the CON group. The ARMD group included 13 males and 11 females, with a mean age of 69.36±9.79 y. The control group included 17 males and 12 females, with a mean age of 64.64±10.31 y. Compared to the CON group, the ARMD group exhibited significantly lower PCPD(31635±4887 vs 38524±3578 cells/mm2, P<0.01)and cell regularity(95.16%±0.75% vs 96.07%±0.67%, P<0.01), along with significantly greater average inter-cell spacing(4.43±0.26 vs 4.22±0.23 μm, P<0.01)and cell dispersion(20.23%±2.72% vs 16.47%±1.85%, P<0.01). Subgroup analysis within the ARMD group revealed that PCPD was significantly lower in the late ARMD subgroup(30831±4826 cells/mm2)compared to the intermediate ARMD subgroup(35254±3534 cells/mm2, P<0.05).CONCLUSION:Photoreceptor pathology in ARMD patients, as assessed by AOSLO, is characterized by decreased PCPD and cell regularity, as well as increased inter-cell spacing and dispersion. These structural alterations are closely associated with photoreceptor cell lesions. AOSLO, as a non-invasive and quantitative imaging modality, demonstrates promising application prospects in the clinical diagnosis of ARMD.
7.Investigating Effect of Xianglian Huazhuo Prescription on Cell Cycle and Proliferation in Rats with Chronic Atrophic Gastritis Through TGF-β1/Smads Signaling Pathway
Yican WANG ; Jie WANG ; Yirui CHENG ; Xiaojing LI ; Yibin MA ; Qiuhua LIU ; Ziwei LIU ; Yuxi GUO ; Pengli DU ; Yanru CAI ; Yao DU ; Zheng ZHI ; Bolin LI ; Qian YANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):128-136
ObjectiveTo explore the potential mechanism of Xianglian Huazhuo prescription (XLHZ) in treating chronic atrophic gastritis (CAG) by regulating cell cycle and inhibiting proliferation, using bioinformatics technology and animal experiments. MethodsDifferential expressed genes (DEGs) related to CAG were screened using GEO database and GEO2R tool. Weighted gene co-expression network analysis (WGCNA) was employed to search for hub genes of CAG. These hub genes were intersected with cell cycle proliferation based on GeneCards database. Eenrichment analysis of the intersecting genes was performed to obtain signaling pathways and biological processes related to CAG. Protein protein interaction (PPI) analysis of genes was conducted using the Protein Interaction Platform (STRING) database to search the super hub gene (hub 2.0), and animal experiments were conducted for further validation. Fourteen of 70 male Wistar rats were randomly selected as the normal group, and the remaining 56 rats were prepared by the combined modeling method of "starvation disorder+N-methyl-N-nitro-N-nitrosoguanidine (MNNG) + sodium salicylate". The successfully modeled rats were randomly divided into the model group, XLHZ-H, XLHZ-M, and XLHZ-L groups (36, 18, 9 g·kg-1, respectively), and Morodan group (1.4 g·kg-1). Each group was given corresponding intervention for 60 days. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of gastric mucosa in rats. The ultrastructure of gastric mucosal tissue cells was observed by transmission electron microscopy. The relative expression levels of TGF-β1, Smad2 and Smad3 proteins, S/G2/M phase marker geminin and proliferation marker MCM2 were detected by Western blot in gastric mucosal tissue, and Spearman correlation analysis was performed. ResultsA total of 15 hub 2.0 genes were identified, including TGF-β1, suggesting the involvement of the TGF-β1 signaling pathway in the CAG pathogenesis. Compared with the normal group, the expressions of TGF-β1, Smad2, geminin and MCM2 proteins in the gastric mucosa tissue of the model group were increased (P<0.05), and the expression of Smad3 protein was decreased (P<0.05). Compared with the model group, the expressions of TGF-β1 and geminin in the gastric mucosa were decreased in the drug groups (P<0.05). The XLHZ-M group, XLHZ-H group and Morodan group had significantly decreased protein expression of Smad2 and MCM2 (P<0.05). The protein expression of Smad3 was significantly increased in XLHZ-M, XLHZ-H, and Morodan groups (P<0.05). Spearman correlation analysis showed that Smad3 was negatively correlated with other indicators, and positively correlated with other indicators (P<0.01). ConclusionXLHZ may inhibit TGF-β1/Smads signaling pathway, regulate cell cycle, and inhibit proliferation in the treatment of CAG.
8.Effect of intraoperative flushing treatment with Nocardia rubra cell-wall skeleton on drainage after radical surgery of lung cancer: A retrospective cohort study
Guanzhi YE ; Zhenyang XU ; Xiaolei ZHU ; Hongming LIU ; Ning LI ; Jie JIANG ; Guojun GENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(03):376-382
Objective To evaluate the efficacy and safety of intraoperative pleural irrigation with Nocardia rubra cell-wall skeleton (N-CWS) for reducing pleural effusion drainage after radical surgery for lung cancer. Methods A retrospective analysis was conducted on the clinical data of lung cancer patients who underwent lobectomy and mediastinal lymph node dissection at the First Affiliated Hospital of Xiamen University between December 2024 and May 2025. Patients were divided into a control group and an irrigation group based on the intraoperative use of N-CWS. Patients in the irrigation group received pleural irrigation with 800 μg of N-CWS diluted in 10 mL of normal saline. The following outcomes were compared between the two groups: pleural effusion drainage volume at 0-24 h, 24-48 h, and 48-72 h postoperatively, degree of air leak, chest tube duration, postoperative length of stay, and the incidence of adverse events (fever, chest pain, and nausea and vomiting). Results A total of 245 patients were included (97 males, 148 females) with a mean age of (61.28±6.26) years, with 205 in the control group and 40 in the irrigation group. Compared to the control group, the irrigation group showed significantly lower pleural effusion drainage volumes at 0-24 h, 24-48 h, and 48-72 h, as well as shorter chest tube duration and postoperative length of stay (all P<0.05). There was no statistical difference in the degree of postoperative air leak (P=0.661). No significant differences were observed between the two groups regarding the highest body temperature within 72 h post-surgery (P=0.130), fever grade (P=0.196), severity of chest pain (P=0.105), or the incidence of nausea and vomiting (P=0.376). Conclusion Intraoperative pleural irrigation with N-CWS in patients undergoing lobectomy and mediastinal lymph node dissection for lung cancer can significantly reduce postoperative pleural effusion drainage volume, shorten chest tube duration and length of hospital stay. The procedure is safe and feasible.
9.Exploration of the Staged and Phased Differentiation and Treatment Approach for Gastric Cancer Immunotherapy Based on the Theory of Shaoyang (少阳) and Shaoyin (少阴) as the Pivots
Wenkang ZHANG ; Yuansha GE ; Kexin LIU ; Jie LI
Journal of Traditional Chinese Medicine 2026;67(7):730-735
Based on the theory that Shaoyang (少阳) and Shaoyin (少阴) function as the principal pivots, and integrating the laws of qi-fire transformation, yin-yang alternation, and the waxing and waning of healthy qi and pathogenic factors, as well as the action characteristics of immune checkpoint inhibitors (ICIs), this study systematically expounds the dynamic evolution laws of the Shaoyang and Shaoyin pivots and constructs a stage- and phase-based differentiation and treatment framework for gastric cancer immunotherapy. In the neoadjuvant treatment stage, the core pathogenesis is the dysfunction of the Shaoyang pivot and the disorder of qi and fire transformation, often accompanied by stagnation of cold-deficiency in the middle jiao (焦). In the postoperative adjuvant treatment stage, the dominant factors are the depletion of Shaoyin fire and the damage of yin fluid, accompanied by the lingering of residual pathogen in the Shaoyang level and the obstruction of collaterals by phlegm and stasis. In the advanced stage, the critical conditions are the exhaustion of the Shaoyin pivot, the blockage of orifices by turbid toxins, and the separation of yin and yang, leading to the rampant of pathogenic toxins and the emergence of various complicated syndromes. The treatment should be guided by the principle of regulating the double pivot. In the neoadjuvant treatment stage, it is recommended to activate the Shaoyang pivot and warm and promote the qi movement in the middle jiao. In the postoperative adjuvant treatment stage, clearing the residual pathogenic factors from the pivot and nourishing the Shaoyin. In the advanced stage, rescuing the Shaoyin pivot and opening the orifices to transform turbidity. Furthermore, stage-based treatment should serve as the foundation for dynamically assessing the patient's immune status and phase-specific changes in immunity, thereby promoting immune activation while preventing and managing immune overactivation and drug resistance.
10.Effect of mesaconate combined with LR on prolonging the golden treatment time window and its resuscitation efficacy for hemorrhagic shock rats under high-altitude conditions
Yuanqun ZHOU ; Xinming XIANG ; Xingnan OUYANG ; Jie ZHANG ; Qinghui LI ; Liangming LIU ; Tao LI
China Pharmacy 2026;37(6):720-726
OBJECTIVE To observe the effects of endogenous metabolite mesaconate combined with Sodium lactate Ringer’s injection (LR) on prolonging the golden treatment time window and its resuscitation efficacy in rats with hemorrhagic shock under high-altitude conditions. METHODS Rats were divided into the shock group, LR group, and 5, 20, 50 mg/kg mesaconate+LR groups, with 20 rats in each group, to investigate the effect of additional use of mesaconate on the golden treatment time window. After establishing a model of uncontrolled hemorrhagic shock under high-altitude conditions in all groups by housing in a hypobaric hypoxia chamber combined with splenic artery transection, rats in the shock group received no resuscitation, while rats in the LR group and mesaconate+LR groups underwent low-pressure resuscitation with LR or mesaconate combined with LR. Blood pressure control, fluid infusion volume, blood loss rate and survival status were observed in each group. Rats were further divided into the normal group, shock group and mesaconate (50 mg/kg)+LR group, with 10 or 20 rats in each group, to evaluate the resuscitation effects after extending the golden treatment time window by additionally using mesaconate. Except for the normal group, the other groups underwent the same procedure to establish an uncontrolled hemorrhagic shock model under high-altitude conditions. Rats in the shock group received no resuscitation. In the mesaconate+LR group, after 3 h of low-pressure resuscitation, bleeding control was performed by ligation of the spleen artery, and the infusion volume and blood loss rate were recorded; subsequently, the rats received LR resuscitation with twice the volume of blood loss. Then, blood gas indicators of the mesaconate+LR group were measured at different time points. Survival rates, indicators related to sublingual microcirculatory perfusion, liver and kidney blood flow, indicators related to the function of vital organs, and lung and brain water content were observed in all groups. RESULTS LR infusion alone could effectively maintain mean arterial pressure (MAP) within 50-60 mmHg for approximately 1 h. The administration of mesaconate combined with LR during hypotensive resuscitation could maintain MAP within 50-60 mmHg for over 3 h, with significantly reduced fluid infusion volume and blood loss rate in 50 mg/kg mesaconate+LR group, compared to the LR group ( P <0.05). In the LR group, rats maintained low pressure for up to 1 hour with a survival rate of 52.94%, and no rats survived beyond 2 h. In the 5, 20 and 50 mg/kg mesaconate+LR groups, rats maintained low pressure for up to 1 h with a survival rate exceeding 80%; in the 20 and 50 mg/kg mesaconate+LR groups, rats maintained low pressure for up to 3 h with a survival rate exceeding 70%. After complete resuscitation with mesaconate combined with LR, the 72 h survival rate of rats was 43.75%, and significant improvements in blood gas parameters were observed compared to the end of the shock phase ( P <0.05). Compared to the shock group, the mesaconate+LR group showed significant recovery in sublingual microcirculatory indicators, and liver/kidney blood flow after complete resuscitation ( P <0.05), with significant reductions in heart, liver and kidney function-related indicators and lung water content ( P <0.05). CONCLUSIONS Mesaconate combined with LR significantly extends the golden treatment time window for hemorrhagic shock in rats under high-altitude conditions, improves blood gas parameters, sublingual microcirculatory perfusion, and liver/kidney blood flow, mitigates vital organ impairment and pulmonary edema, and increases the survival rate of shocked rats.

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