1.Research advances in mitochondrial dysfunction in the pathogenesis of hepatic fibrosis
Yudie HONG ; Jinchen GUO ; Weibing SHI ; Yujie SUN ; Jiamin WANG ; Tiantian GAO
Journal of Clinical Hepatology 2026;42(1):190-196
Hepatic fibrosis refers to excessive accumulation and abnormal proliferation of fibrous connective tissue in the liver triggered by multiple pathogenic factors, and it may progress to liver cirrhosis, portal hypertension, and liver cancer. The pathological mechanisms of hepatic fibrosis involve hepatocyte injury, inflammatory cell infiltration with the release of inflammatory mediators, hepatic stellate cell activation, and extracellular matrix deposition. Recent studies have focused on mitochondrial dysfunction in disease progression, including the molecular pathways for hepatic fibrosis driven by metabolic disorders, energy deficiency, oxidative stress, mitochondrial dynamic imbalance, and autophagic dysfunction, all of which can induce liver injury. This article reviews the latest advances in hepatic fibrosis, in order to provide new therapeutic strategies for clinical management.
2.Construction and Application of A Digital System for "Disease-pulse-syndrome-treatment Differentiation" Paradigm
Tiantian FAN ; Ying LYU ; Ru NIU ; Xiaojie KANG ; Fenglan WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):217-225
In the context of the digital-intelligent era of traditional Chinese medicine (TCM), the lack of clinical thinking is a pressing issue that limits the overall effectiveness of TCM and talent cultivation. The "disease-pulse-syndrome-treatment differentiation" thinking model, originally developed by ZHANG Zhongjing in the Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Za Bing Lun), has served as a guideline and paradigm followed by generations of medical practitioners. This study aims to construct a digitalized "disease-pulse-syndrome-treatment differentiation" thinking system, develop a digital assessment system, and implement it for practical application. The goal is to recommend a digitalized assessment model for TCM and provide a reference for the integrated innovation of talent cultivation in medicine, education, and research. First, based on the complex diagnostic and treatment framework of the Treatise on Cold Damage Diseases (Shang Han Lun), the research team previously established a "process" + "result" thinking model that included four processes and ten steps. This study integrates knowledge unit theory and digital technology to create a digital system for "disease-pulse-syndrome-treatment differentiation" with a dual-control model of "process control" and "result control". The system consists of 46 items across three categories: knowledge body (W=20%), knowledge element (W=30%), and knowledge element associations (W=50%). Second, a mixed-methods research design was employed, combining qualitative and quantitative approaches. The Delphi method was used to establish hierarchical levels and screen items, while the analytic hierarchy process (AHP) was used to assign weights. Expert surveys were conducted to reach a consensus and further validate the rationale and necessity of the system. Finally, based on the system architecture and integrating key computer technologies, a digital assessment system for "disease-pulse-syndrome-treatment differentiation" was developed. The Treatise on Cold Damage Diseases (Shang Han Lun) was used as a case study to validate the system's feasibility. Statistical results showed that the difficulty level of the assessment question bank was moderate (DL ranging from 0.65 to 0.89), with good discrimination (D>0.4), and reasonable reliability and validity (Cronbach's α=0.84, KMO=0.72, Bartlett's test P<0.01). The system can perform process-oriented evaluations of candidates' thinking in "disease-pulse-syndrome-treatment differentiation" and effectively achieve the goal of clinical thinking assessment through a combination of "process control" and "result control". The examination system offers three major advantages. It standardizes, objectifies, and streamlines the assessment of thought processes, facilitates the organic transformation of TCM education from outcome-based education to thinking-based education, and from exam-oriented education to competency-oriented education, and promotes the practical transformation of TCM assessments from qualitative to quantitative evaluation, as well as from theory to practice. In summary, this system not only represents a technological upgrade to traditional examinations but also empowers the cultivation and assessment of clinical talent in the digital-intelligent era, demonstrating broad application prospects.
3.Interpretation and thoughts on the formulation and revision of the standards for exogenous harmful residues in traditional Chinese medicinal materials in the Chinese Pharmacopoeia 2025 Edition
WANG Ying ; SHEN Mingrui ; LIU Yuanxi ; ZUO Tiantian ; WANG Dandan ; HE Yi ; CHENG Xianlong ; JIN Hongyu ; LIU Yongli ; WEI Feng ; MA Shuangcheng
Drug Standards of China 2025;26(1):083-092
As people’s attention to health continues to increase, the market demand for traditional Chinese medicine (TCM) is growing steadily. The quality and safety of Chinese medicinal materials have attracted unprecedented social attention. In particular, the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society. The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM. This not only reflects China’s high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision. Basis on this study, by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detection standards in the Chinese Pharmacopoeia 2025 Edition, deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition. Moreover, it interprets the future development directions of the detection of exogenous residues in TCM, aiming to provide a reference for the formulation of TCM safety supervision policies.
4.Effects of different storage temperatures and durations on the activity of coagulation factor Ⅷ and Ⅸ in whole blood
Hehe WANG ; Tiantian WANG ; Jie WANG ; Cuicui QIAO ; Wei LIU ; Xueqin ZHANG ; Yan CHENG ; Yunhai FANG ; Xinsheng ZHANG
Chinese Journal of Blood Transfusion 2025;38(6):824-827
Objective: To investigate the effects of different storage temperatures and durations on the activities of coagulation factor Ⅷ (Factor Ⅷ, FⅧ) and coagulation factor Ⅸ (Factor Ⅸ, FⅨ) after whole blood collection, so as to provide data support for the optimal storage conditions. Methods: A total of 16 mL of whole blood was collected from each of the 20 healthy volunteers at our blood center and aliquoted into 8 sodium citrate anticoagulant tubes. Two tubes were immediately centrifuged for the measurement of FⅧ and FⅨ activity levels. The remaining 6 tubes of whole blood were respectively stored under room temperature and low-temperature conditions. At 2, 4, and 6 h, the whole blood samples were centrifuged and analyzed for FⅧ and FⅨ activity levels. The mean values of the two immediately tested tubes were used as the control group, while other tubes were designated as the experimental groups for comparison. Statistical analysis was performed using SPSS 26.0. Results: The activity of FⅧ in whole blood remained stable after 4 hours of storage at both room temperature and low temperature (116.53±25.95 vs 125.22±27.33, 109.77±23.23 vs 125.22±27.33) (P>0.05 for both). However, by 6 hours, FⅧ activity showed a statistically significant decline compared to the control group (108.65±22.92 vs 125.22±27.33, 100.46±20.19 vs 125.22±27.33) (P<0.05 for both), though the room temperature group results were closer to the control values. The activity of FⅨ in whole blood remained stable after 6 hours of storage under both conditions (97.14±19.48 vs 96.76±19.67, 97.10±17.45 vs 96.76±19.6) (P>0.05 for all comparisons). Conclusion: For whole blood samples after collection, storage at either room temperature or low temperature for up to 4 hours does not compromise the accuracy of test results. When stored for 6 hours, FⅨ activity remains stable, whereas FⅧ activity decreases significantly. Notably, FⅧ activity demonstrates better stability at room temperature than under low-temperature conditions within the 6-hour storage.
5.Associations of volatile organic compounds/semi-volatile organic compounds exposure on asthma: A review of epidemiological studies and diagnostic applications
Tiantian GU ; Jin ZHANG ; Teng YANG ; Jiawei WANG ; Qinsheng KONG ; Guoxing LI ; Jing HUANG
Journal of Environmental and Occupational Medicine 2025;42(6):756-761
Volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are common organic compounds in indoor and outdoor air, and enter the human body primarily through the respiratory tract and directly damage the respiratory system. Previous studies have suggested that exposure to VOCs/SVOCs may associate with the prevalence, incidence, and progression of asthma, but the extent of the associations is still vague. Furthermore, biomarkers for efficient and simple asthma diagnosis, typing, and attack prediction remain unclear at this stage. From the perspective of the collection and detection methods of VOCs/SVOCs, this paper summarized the epidemiological associations and underlying biological mechanisms between VOCs/SVOCs exposure and the prevalence, incidence, and progression of asthma in children/adults. It also demonstrated the application of VOCs/SVOCs in recent years in assisting asthma diagnosis, such as distinguishing asthma patients from the healthy population, differentiating different asthma phenotypes, and predicting asthma acute exacerbations, aiming to provide a scientific basis for improving current asthma management.
6.Improving the level of environmental sanitation and promoting the healthy growth of children
WANG Qiang, ZHANG Can, LI Tiantian
Chinese Journal of School Health 2025;46(7):913-916
Abstract
Effective response to environmental health risks is the key to ensuring the healthy growth of children. The Chinese government has implemented policies, regulations, standards and pollution control measures to promote the overall improvement of children s environmental health. However, facing the still severe traditional and emerging environmental risks, it is still necessary to further integrate multiple resources and carry out precise prevention and control of children s environmental health risks. The paper focuses on both traditional and emerging key environmental health challenges affecting children s health in China, including air pollution from solid fuels, drinking water contamination and escalating threat of climate change; and it offers systematic recommendations across three levels:advancing scientific research, strengthening government policy guidance and implementing actions in schools and communities, aiming to create a safer and healthier growth environment for children.
7.Nasal-to-Brain Drug Delivery Strategies for Active Ingredients of Traditional Chinese Medicine:A Review
Yang CHEN ; Tiantian WANG ; Yufang HUANG ; Guangdi YANG ; Shengmou HU ; Xiaomeng LEI ; Wenliu ZHANG ; Dongxun LI ; Canjian WANG ; Guosong ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):252-261
Central nervous system(CNS) disorders are characterized by complex pathological mechanisms and the presence of the blood-brain barrier(BBB), which significantly limits the effectiveness of drug therapy. Traditional drug delivery modes include oral administration, intravenous injection and transdermal delivery, which have certain advantages, but it is difficult for the drugs to effectively cross the BBB. Therefore, it is crucial to find drug delivery modes that can efficiently traverse the BBB. Nasal drug delivery, as a non-invasive method, can realize the targeted delivery of drugs to the CNS via three pathways, including olfactory neurons, trigeminal neurons and blood circulation, and shows a broad application prospect in the treatment of CNS diseases. Numerous studies have further confirmed that nasal drug delivery combined with novel drug delivery systems such as lipid nanocarriers, nanoparticles, nanoemulsions and composite in situ gels can effectively load the active components of traditional Chinese medicine(TCM), and significantly increase drug concentration in the brain, which provides new strategies for the treatment of CNS diseases. In this paper, the current status of drug delivery for CNS diseases was systematically sorted out, the characteristics of nasal drug delivery were discussed in depth, and the research progress of passive targeting, active targeting, and "guiding the meridian" drug delivery strategies for the nasal-to-brain transport of TCM active components was summarized and analyzed, which was aimed to provide references and insights for the development of drugs for CNS diseases and the application of TCM in nasal-to-brain delivery.
8.Nasal-to-Brain Drug Delivery Strategies for Active Ingredients of Traditional Chinese Medicine:A Review
Yang CHEN ; Tiantian WANG ; Yufang HUANG ; Guangdi YANG ; Shengmou HU ; Xiaomeng LEI ; Wenliu ZHANG ; Dongxun LI ; Canjian WANG ; Guosong ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):252-261
Central nervous system(CNS) disorders are characterized by complex pathological mechanisms and the presence of the blood-brain barrier(BBB), which significantly limits the effectiveness of drug therapy. Traditional drug delivery modes include oral administration, intravenous injection and transdermal delivery, which have certain advantages, but it is difficult for the drugs to effectively cross the BBB. Therefore, it is crucial to find drug delivery modes that can efficiently traverse the BBB. Nasal drug delivery, as a non-invasive method, can realize the targeted delivery of drugs to the CNS via three pathways, including olfactory neurons, trigeminal neurons and blood circulation, and shows a broad application prospect in the treatment of CNS diseases. Numerous studies have further confirmed that nasal drug delivery combined with novel drug delivery systems such as lipid nanocarriers, nanoparticles, nanoemulsions and composite in situ gels can effectively load the active components of traditional Chinese medicine(TCM), and significantly increase drug concentration in the brain, which provides new strategies for the treatment of CNS diseases. In this paper, the current status of drug delivery for CNS diseases was systematically sorted out, the characteristics of nasal drug delivery were discussed in depth, and the research progress of passive targeting, active targeting, and "guiding the meridian" drug delivery strategies for the nasal-to-brain transport of TCM active components was summarized and analyzed, which was aimed to provide references and insights for the development of drugs for CNS diseases and the application of TCM in nasal-to-brain delivery.
9.Precision infusion of cryoprecipitate in rare bleeding disorders
Changkui SUN ; Tiantian WANG ; Jie WANG ; Yunhai FANG
Chinese Journal of Blood Transfusion 2025;38(9):1150-1153
The coagulation factors in cryoprecipitate are mainly coagulation factor Ⅷ, fibrinogen, von Willebrand factor (VWF), and coagulation factor ⅩⅢ. This article provides different treatment dosages and plans for different patients with rare coagulation disorders based on their actual conditions referring to international and domestic guidelines and consensus. In order to achieve precise infusion for cryoprecipitate, it is necessary to avoid poor treatment effects caused by insufficient doses, as well as waste of blood components and the risk of thrombosis caused by excessive infusion.
10.Correlation between APTT mixing test results and inhibitor titers in patients with hemophilia A inhibitor
Tiantian WANG ; Yan CHENG ; Hehe WANG ; Cuicui QIAO ; Jie WANG ; Guangshang ZHONG ; Xiyuan WANG ; Xueqin ZHANG ; Yunhai FANG
Chinese Journal of Blood Transfusion 2025;38(9):1172-1176
Objective: To study the correlation between activated partial thromboplastin time (APTT) mixing test results and the inhibitor titers in hemophilia A inhibitor-positive patients. Methods: In this cross-sectional study, 41 patients with severe hemophilia A and inhibitors (and negative for lupus anticoagulant) were included from the hemophilia clinic of Shandong Blood Center from February 2022 to February 2024. All patients underwent APTT mixing test. The Rosner's index (RI, including the immediate RI and the RI after 2-hour water bath incubation [water bath 2h RI]), the time-dependent difference (Δ value), and the corrected percentage were calculated based on results of APTT mixing test. The median (interquartile range) of the corresponding indexes were calculated, and the ROC curves for identification of high inhibitor titers using the four indexes (the immediate RI, the water bath 2h RI, the Δ value, and the corrected percentage) were plotted, The correlations between APTT mixing test and inhibitor titers for coagulation factor Ⅷ (Factor Ⅷ, FⅧ) were investigated. Results: The median (lower quartile, upper quartile) of immediate RI, water bath 2h RI, Δ-value and corrected percentage for FⅧ inhibitor positive patients were 11.0 (5.4, 29.3)%, 45.0 (25.7, 75.0)%, 26.2 (7.6, 41.8) s, and 82.2 (58.5, 91.6)%, respectively. The median (lower quartile, upper quartile) of the immediate RI, water bath 2h RI, Δ-value and corrected percentage were 25.2 (13.0, 37.5)%, 64.1 (44.6, 72.6)%, 38.0 (14.3, 38.3) s, and 66.5 (50.1, 82.1)% for the high-titer inhibitor group, and 5.2 (4.2, 9.4)%, 17.9 (8.8, 28.0)%, 13.0 (7.6, 25.4) s, and 92.3 (88.0, 94.3)% for the low-titer inhibitor group. The AUCs of the ROC curves for discrimination between high and low titer inhibitor were: 0.9105 for immediate RI, 0.9118 for water bath 2h RI, 0.8873 for correcter percentage, and 0.6532 for Δ-value. Conclusion: High-titer inhibitors can be highly suspected in hemophiliac patients with an immediate RI >10% and a water bath 2h RI >45%, and the presence of low-titer inhibitors is suspected in patients with a 4-second < immediate RI <10% and a 13% < water bath 2h RI <45%.


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