1.Association of traditional Chinese medicine syndromes with blood lipid profiles and cardiovascular prognosis in post-percutaneous coronary intervention atherosclerotic cardiovascular disease patients: a prospective cohort study
Huangyu XU ; Qian LI ; Haozhe XIONG ; Weidong HONG ; Xinyi ZHOU ; Xiaoyan LU ; Xiaoli LIU ; Xinrong FAN
Digital Chinese Medicine 2026;9(1):91-102
Objective:
Patients with atherosclerotic cardiovascular disease (ASCVD) following percutaneous coronary intervention (PCI) are classified as very-high-risk individuals in cardiovascular disease (CVD) risk stratification. The distribution pattern of traditional Chinese medicine (TCM) syndromes in this patient population, as well as its association with blood lipid profiles and clinical prognosis, remains unclear. The present prospective cohort study aims to investigate these correlations, thereby providing insights to enrich the research fields.
Methods:
We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1, 2020 and December 31, 2022. Demographics and clinical characteristics, signs and symptoms defining each TCM syndrome, and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events (MACEs). We analyzed the correlation between TCM syndromes, blood lipid profiles, and MACEs, and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression. The analyses were based on detailed baseline and one-year follow-up data.
Results:
A per-protocol analysis was performed on 586 patients with complete data ultimately. During the one-year follow-up, 174 patients (29.69%) experienced a MACE. We performed statistical analyses on comorbidities, medication, and biochemical indicators across groups defined by TCM syndrome differentiation. When comparing different TCM syndromes, no significant differences were found in age, body mass index (BMI), history of revascularization, comorbidities, family history of CVD, smoking or drinking, or statin intensity (P > 0.05). Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol (TC, 5.27 ± 1.18 mmol/L, P < 0.001), triglyceride (TG, 1.96 ± 1.33 mmol/L, P = 0.008), low-density lipoprotein cholesterol (LDL-C, 3.35 ± 0.79 mmol/L, P < 0.001), and high-density lipoprotein cholesterol (HDL-C, 1.24 ± 0.81 mmol/L, P < 0.001) compared with those with other TCM syndromes combined. A multivariable logistic regression model was constructed to predict MACEs. The model included TCM syndrome type [with intertwined phlegm and blood stasis as a predictor, adjusted odds ratio (OR) = 1.413, 95% confidence interval (CI): 0.517 – 3.864, P = 0.501], age (adjusted OR = 0.97, 95% CI: 0.955 – 1.001, P = 0.057), male gender (adjusted OR = 0.698, 95% CI: 0.416 – 1.170, P = 0.173), TC (adjusted OR = 1.004, 95% CI: 0.513 – 1.965, P = 0.990), and LDL-C (adjusted OR = 5.825, 95% CI: 2.214 – 15.326, P < 0.001). This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients [the area under the receiver operating characteristic (ROC) curve (AUC) = 0.865, 95% CI: 0.816 – 0.914].
Conclusion
The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C. The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters (TC and LDL-C) shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI, underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.
2.Pathogenesis and Treatment Strategy of "Macrocirculation-Microcirculation" Uncoupling in Sepsis:from the Perspective of "Deep Heat,Deep Syncope"
Xinyi XU ; Yuyang LAN ; Xinyue WANG ; Ying GAO ; Ziqi SHAN ; Xiaokun YANG ; Lu XIAO
Journal of Traditional Chinese Medicine 2026;67(13):1403-1408
By reviewing modern research and integrating clinical practice, this paper interprets the correlation between "deep heat, deep syncope" and the "macrocirculation-microcirculation" uncoupling in sepsis, alongside its clinical applications in sepsis prevention and treatment. It is considered that "deep heat" corresponds to peripheral vasodilation and the hypermetabolic state at the macrocirculation level, whereas "deep syncope" manifests as hypoperfusion and impaired oxygen utilization at the microcirculation level. These two states interact detrimentally, forming the core contradiction of macrocirculation-microcirculation uncoupling in sepsis. Based on the traditional Chinese medicine (TCM) connotations of "deep heat, deep syncope" and modern medical research, this paper elucidates the systemic pathological evolution of sepsis from the inflammatory cascade to impaired oxygen utilization. Accordingly, the following therapeutic principles are proposed. In the early stage, it is suggested to clear heat and drain fire to vent the constrained yang. In the progressive stage, the focus is put on unblocking the lower jiao (焦) and expelling stasis to dredge the vessels and collaterals. In the recovery stage, the method of regulating and harmonizing yin and yang can be used to smooth the flow of qi and blood.
3.Fecal microbiota transplantation for the treatment of cirrhotic ascites with chronic diarrhea: A case report
Dan ZHAO ; Jiaru ZHAO ; Honghong CAO ; Qiaoli GUO ; Wei WU ; Xinyi ZHANG ; Cuiping XU ; Jie ZHANG
Journal of Clinical Hepatology 2026;42(6):1383-1387
Fecal microbiota transplantation (FMT) has been widely used in the treatment of gastrointestinal disorders, particularly Clostridium difficile infection, while there are few reports of its application in the diagnosis and treatment of cirrhotic ascites. This article reports a case of a patient with cirrhotic ascites and chronic diarrhea who received FMT with oral capsules, demonstrating significant short-term efficacy without any adverse reactions, in order to provide a reference for the application of FMT in the treatment of liver diseases.
4.Metabolic characteristics and related influencing factors in patients with diabetic retinopathy
Siman LIU ; Xinyi SUN ; Jing GE ; Xu YU ; Junjun MIAO
Chinese Journal of Clinical Medicine 2026;33(4):636-642
Objective To explore the metabolic characteristics and related factors in patients with diabetic retinopathy (DR). Methods A retrospective study was conducted on the clinical data of 467 diabetic patients hospitalized at the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to September 2024. The patients were divided into the DR group (n=150) and the non-DR group (n=317). Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using a transient elastography device, and graded into five levels. Basic data, LSM and CAP grading, and metabolic indicators were compared between the two groups. Univariate and multivariate logistic regression analyses were applied to identify factors influencing DR. Results Patients in the DR group were older than those in the non-DR group (P<0.001). Compared with the non-DR group, fasting blood glucose (FBG), glycated hemoglobin A1C (HbA1C), and triglyceride (TG) levels were higher, while low-density lipoprotein cholesterol (LDL-C) was lower in the DR group (P<0.05). Significant differences in LSM grading were observed between the two groups (P=0.006). Multivariate logistic regression analysis revealed that LSM grading (grade 2: OR=2.127, P=0.002; grade 3: OR=2.344, P=0.030; grade 4: OR=2.960, P=0.038), FBG (OR=1.233, P<0.001), and serum creatinine (OR=1.013, P=0.006) were independent factors associated with DR. Conclusions FBG, serum creatinine, and LSM are related factors of DR. In clinical practice, attention should be paid to the coordinated management of blood glucose control, renal function monitoring, and liver fibrosis assessment, with early interventions to reduce the risk of DR.
5.Overview of the amendments and revisions to the General Technical Requirements adopted by the Volume Ⅳ of the Chinese Pharmacopoeia 2025 Edition
ZHANG Jun ; NING Baoming ; WEI Shifeng ; SHEN Haoyu ; SHANG Yue ; ZHU Ran ; XU Xinyi ; CHEN Lei ; LIU Tingting ; MA Shuangcheng
Drug Standards of China 2025;26(1):034-044
To introduce the general thinking, guidelines, work objectives and elaboration process of the general technical requirements adopted by volume Ⅳ of the Chinese Pharmacopoeia 2025 Edition, and to summarize and figure out the main characteristics on dosage forms, physico-chemical testing, microbial and biological testing, reference standards and guidelines The newly revised general chapters of pharmacopoeia give full play to the normative and guiding role of the Chinese Pharmacopoeia standard, track the frontier dynamics of international drug regulatory science and the elaboration of monographs, expand the application of state-of-the-art technologies, and steadily promote the harmonization and unification with the ICH guidelines; further enhance the overall capacity of TCM quality control, actively implement the 3 R principles on animal experiments, and practice the concept of environmental-friendly; replace and/or reduce the use of toxic and hazardous reagents, strengthen the requirements of drug safety control This paper aims to provide a full-view perspective for the comprehensive, correct understanding and accurate implementation of general technical requirements included in the Chinese Pharmacopoeia 2025 Edition.
6.Additions and revisions of general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition Volume Ⅳ
XU Xinyi ; WEI Shifeng ; ZHANG Qiming ; HE Langchong ; ZHANG Jun ; MA Shuangcheng
Drug Standards of China 2025;26(1):045-050
Objective: To provide reference for the correct understanding and accurate implementation of the general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition Volume Ⅳ.
Methods: Introduce the main characteristics and content of the additions and revisions of the general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition Volume Ⅳ.
Results: The general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition are more harmonized with the relevant guidelines of the ICH Q series, and the inclusion of advanced and mature instrument analysis technology standards and analysis method standards related to drug safety, efficacy, and quality controllability is further increased.
Conclusion: The general chapters of physical and chemical analysis in the Chinese Pharmacopoeia 2025 Edition have provided a more convenient new bridge for China’s drugs to go international, standardized testing technology support for achieving full process quality control, and better meet the needs of drug research and development, production, quality control, and supervision in China.
7.Analysis of Coordination Strategies with ICH Q3C for Residual Solvent Control in Pharmacopoeia of Various Countries
Min CHEN ; Weicong WU ; Xinyi XU ; Suming WANG ; Xiao LING ; Qiming ZHANG ; Ying CHEN ; Lei CHEN
Herald of Medicine 2025;44(2):227-235
Objective To analyze the coordination strategies of residual solvent control in various pharmacopoeias with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Guidelines for residual solvents(ICH Q3C),aiming to provide ideas and solutions for coordinating residual solvents in the Chinese Pharmacopoeia with ICH Q3C.Methods Through literature research and review,compare the coordination process between residual solvent control in various pharmacopoeias and ICH Q3C,analyze the implementation strategies of mainstream pharmacopoeia residual solvent control and ICH Q3C coordination in foreign countries,and clarify the differences in residual solvent control between the Chinese Pharmacopoeia and foreign pharmacopoeias.Results It is necessary to coordinate the control of residual solvents in the Chinese Pharmacopoeia with ICH Q3C.Conclusion It is recommended to steadily promote the overall coordination of residual solvent control in Chinese pharmacopoeia and ICH by drawing on the experience of coordination between foreign pharmacopoeias and ICH Q3C,based on the national conditions of China.
8.Three-dimensional speckle tracking imaging in evaluation on right ventricular function for predicting adverse events in patients with unstable angina after PCI
Wenshu HU ; Chang ZHOU ; Liang XU ; Heng SUN ; Shuting NIE ; Yuanyuan SHAO ; Xinyi LI
Chinese Journal of Interventional Imaging and Therapy 2025;22(2):102-106
Objective To observe the value of three-dimensional speckle tracking imaging(3D-STI)in evaluation on right ventricle(RV)function for predicting adverse events in patients with unstable angina(UA)after percutaneous coronary intervention(PCI).Methods A total of 155 UA patients who underwent both 3D-STI and conventional echocardiography and planned to accept PCI were prospectively enrolled and divided into adverse event group(n=37)and control group(n=118)based on the occurrence of adverse events after PCI or not.Clinical data and echocardiographic parameters were compared between groups,and new binary variables were generated according to the optimal cut-off values showed by the maximum Youden index of receiver operating characteristic curves of 3D-STI parameters being statistically different between groups.Then the independent predictors of adverse events among UA patients after PCI were analyzed,a combined model was constructed,and its predictive value was assessed.Results In adverse event group,the left ventricular end diastolic volume(LVEDV)was higher,while the left ventricular ejection fraction(LVEF),right ventricular free wall longitudinal strain(RVFWLS)and right ventricular global longitudinal strain(RVGLS)were all lower than those in control group(all P<0.05).The optimal cut-off values for distinguishing adverse event or not was 110 ml for LVEDV,19.05%for RVFWLS and 19.75%for RVGLS,respectively,and all the 3 generated binary variables were independent predictors for adverse events of UA patients after PCI(all P<0.05).The area under the curve of combined model for predicting adverse events in UA patients after PCI was 0.864.Conclusion RVFWLS<19.05%and RVGLS<19.75%obtained with 3D-STI,as well as LVEDV>110 ml with conventional echocardiography were all independent predictors of adverse events in UA patients after PCI.
9.Effects of ballet training on walking parameters in children with spastic cerebral palsy
Xinyi ZHAI ; Chunxin XU ; Yangyang LU
Chinese Journal of Rehabilitation Medicine 2025;40(10):1504-1509
Objective:To investigate the influence of ballet training on walking parameters of children with spastic cere-bral palsy.Method:A total of 24 children with cerebral palsy were selected and randomly grouped by 1:1 matching according to similar age,same sex and GMFCS grading,namely 12 cases in the experimental group and 12 cases in the control group.The experimental group received ballet training combined with conventional rehabilitation treatment,and the control group received conventional rehabilitation treatment.The intervention time was 3 months.Three-dimensional gait analysis technology was used to collect the subjects'kinematic and dynamic parameters and gait deviation index(GDI)before and after the intervention,and to analyze the difference of efficacy between the two groups.Result:There was no significant difference in kinematics,dynamics and GDI between the two groups before treatment.Comparison between the two groups after treatment:Kinematic parameters:before and after interven-tion,maximum flexion angle of bilateral hip joint in the brace phase,maximum extension angle of bilateral hip joint,maximum flexion angle of right hip joint in the swing phase,maximum extension angle of right hip joint and maximum plantar flexion angle of right ankle in the experimental group had no obvious differenc-es(P<0.05).Dynamic parameters:Before and after intervention,the maximum plantar flexion moment of the left ankle in the supporting phase and the shock absorption capacity of the left ankle had significant differences(P<0.05).After intervention,there were significant differences between the two groups:maximum plantar flex-ion moment of the right ankle in the support phase,maximum work of the right hip joint,maximum reaction force on the left side and shock absorption capacity of bilateral ankle joints(P<0.05).Conclusion:Ballet training combined with conventional rehabilitation therapy can significantly improve the function of hip extension muscle,hip flexor muscle and foot flexor muscle in the children with spastic CP,and the efficacy is better than conventional rehabilitation training.This study provides a new idea for dance therapy of CP children in the future.
10.Audit indicators development and obstacle factors analysis for perioperative frailty management in elderly patients
Xinyi ZHONG ; Xingxing LU ; Jingyan YANG ; Lifen XU
Chinese Journal of Practical Nursing 2025;41(29):2249-2256
Objective:To conduct a baseline review of the best evidence for perioperative fraility management in elderly patients, construct review indicators, systematically analyze obstacle factors and promoting factors, and formulate corresponding change strategies, so as to provide reference for clinical transformation of evidence.Methods:With the Joanna Briggs Institute evidence-based health care model as the guiding framework, the best evidence of perioperative frailty-management in elderly patients was summarized, and the review indicators and review methods were formulated on the basis of the evidence. From April 2024 to May 2024, a baseline review of the hospital system of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, medical staff and patients were conducted to analyze the obstacles in clinical practice and formulate corresponding change strategies, guided by integrated-promoting action on research implementation in health services framework(i-PARIHS).Results:According to 19 best evidence, 20 review indicators were established, among which 10 review indicators compliance rate was less than 60% and higher than 0, 2 review indicators compliance rate was 0. Based on the results of the i-PARIHS evidence-based conceptual framework analysis, the obstacle factors included the evidence content was not specific and inaccessible; lack of knowledge and skills in healthcare; the workload of medical care increased; the patient was old and had weak receptivity, lack of systematic practice process; lack of multidisciplinary communication mechanisms.Conclusions:There is a big gap between the best evidence of perioperative frailties management in elderly patients and clinical practice. Clinical departments need to deeply analyze the obstacles to clinical practice based on the existing clinical environment and resource allocation, and formulate targeted strategies to promote the better integration of evidence into clinical practice.

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