1.Theory and practice of medical humanistic care: a decade of implementation by the medical humanities team at Harbin Medical University
Yu WANG ; Xuesong WU ; Mei YIN
Chinese Medical Ethics 2026;39(2):182-187
On October 9, 2024, the General Office of the National Health Commission, the General Office of the Ministry of Education, the General Department of the National Administration of Traditional Chinese Medicine, and the General Department of the National Bureau of Disease Control and Prevention jointly issued the Action Plan for Enhancing Medical Humanistic Care (2024-2027), stating that medical humanistic spirit is a concrete manifestation of humanistic spirit in the medical field. Aiming at caring for and respecting patients, this spirit reflects the attitude of medicine towards life. The cultivation of medical humanistic care competencies should serve as a core element of modern medical education, running through the entire process of the medical students’ training system and the full stage of medical workers’ career development. The humanities team of Harbin Medical University pioneered the “consistent system” concept of medical humanities education, inherited the “four-stage” with clinical practice as the primary approach, and closely focused on “three combinations, two considerations, and one assessment.” Through deeply integrating medicine with the humanities, as well as theory with practice, they have embarked on a distinctive implementation path of medical humanities, laying a solid foundation for the cultivation of high-quality medical talents with both skills and expertise in practice.
2.Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma Regulates Ferroptosis via Nrf2/SLC7A11/GPX4 Signaling Pathway to Alleviate Myocardial Remodeling in Rat Model of Myocardial Infarction
Xuesong CHEN ; Rongnan QIU ; Shenghao WANG ; Yan FENG ; Jutong XIE ; Yuwen YAN ; Tianlin YANG ; Changxu XIE ; Lei GAO ; Jianping SHEN ; Yuehong SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):54-62
ObjectiveTo investigate the effect of Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma on ferroptosis in the rat model of myocardial infarction and further elucidate its role in myocardial remodeling. MethodsThe rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. The 50 successfully modeled rats were randomly divided into model group, ferroptosis inhibitor group (2 mg·kg-1), enalapril group (2.1 mg·kg-1), and low- and high-dose (4 g·kg-1 and 8 g·kg-1, respectively) Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma, with 10 rats in each group. The rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. After 4 weeks of treatment, echocardiography was used to assess the cardiac structure and function. Hematoxylin-eosin (HE) staining and Masson staining were employed to observe pathological morphology and fibrosis of the myocardial tissue. Serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), transforming growth factor-β (TGF-β), and myosin heavy chain-β (MHC-β) were measured by enzyme-linked immunosorbent assay (ELISA). Prussian blue staining was performed to detect myocardial iron deposition. The myocardial mitochondrial structure was observed by transmission electron microscopy. Levels of malondialdehyde (MDA) and glutathione (GSH) in the myocardial tissue were determined by lipid peroxidation assay kits. Immunofluorescence assay was conducted to observe the fluorescence intensity of nuclear factor E2-related factor 2 (Nrf2) in the myocardial tissue. Western blot analysis was performed to evaluate the expression levels of proteins in the Nrf2/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway. ResultsCompared with the sham group, the model group showed increased left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01), disarrangement of myocardial cells, inflammatory cell infiltration, severe myocardial fibrosis, increased myocardial iron deposition, and irregular mitochondrial morphology with vacuolation. Furthermore, the modeling led to increased MDA (P<0.01), decreased GSH (P<0.01), diminished Nrf2 fluorescence intensity in the myocardial tissue, and downregulated expression levels of Nrf2, SLC7A11, and GPX4 (P<0.01). Compared with the model group, Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma reduced the LVEDD, LVESD, and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.05, P<0.01), increased the LVEF and LVFS (P<0.05, P<0.01), alleviated pathological changes such as myocardial cell disarrangement, inflammatory cell infiltration, myocardial fibrosis, and iron deposition, lowered the level of MDA (P<0.05, P<0.01), raised the level of GSH (P<0.05, P<0.01), improved the mitochondrial morphology and reduced vacuolation in the myocardial tissue, enhanced Nrf2 fluorescence intensity, and upregulated the expression levels of Nrf2, SLC7A11, and GPX4 (P<0.05, P<0.01) in the rat model of myocardial infarction. ConclusionGardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma alleviates pathological damage and myocardial remodeling in the rat model of myocardial infarction by inhibiting ferroptosis, the mechanism of which is related to the activation of Nrf2/SLC7A11/GPX4 signaling pathway.
3.Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma Regulates Ferroptosis via Nrf2/SLC7A11/GPX4 Signaling Pathway to Alleviate Myocardial Remodeling in Rat Model of Myocardial Infarction
Xuesong CHEN ; Rongnan QIU ; Shenghao WANG ; Yan FENG ; Jutong XIE ; Yuwen YAN ; Tianlin YANG ; Changxu XIE ; Lei GAO ; Jianping SHEN ; Yuehong SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):54-62
ObjectiveTo investigate the effect of Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma on ferroptosis in the rat model of myocardial infarction and further elucidate its role in myocardial remodeling. MethodsThe rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. The 50 successfully modeled rats were randomly divided into model group, ferroptosis inhibitor group (2 mg·kg-1), enalapril group (2.1 mg·kg-1), and low- and high-dose (4 g·kg-1 and 8 g·kg-1, respectively) Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma, with 10 rats in each group. The rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. After 4 weeks of treatment, echocardiography was used to assess the cardiac structure and function. Hematoxylin-eosin (HE) staining and Masson staining were employed to observe pathological morphology and fibrosis of the myocardial tissue. Serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), transforming growth factor-β (TGF-β), and myosin heavy chain-β (MHC-β) were measured by enzyme-linked immunosorbent assay (ELISA). Prussian blue staining was performed to detect myocardial iron deposition. The myocardial mitochondrial structure was observed by transmission electron microscopy. Levels of malondialdehyde (MDA) and glutathione (GSH) in the myocardial tissue were determined by lipid peroxidation assay kits. Immunofluorescence assay was conducted to observe the fluorescence intensity of nuclear factor E2-related factor 2 (Nrf2) in the myocardial tissue. Western blot analysis was performed to evaluate the expression levels of proteins in the Nrf2/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway. ResultsCompared with the sham group, the model group showed increased left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01), disarrangement of myocardial cells, inflammatory cell infiltration, severe myocardial fibrosis, increased myocardial iron deposition, and irregular mitochondrial morphology with vacuolation. Furthermore, the modeling led to increased MDA (P<0.01), decreased GSH (P<0.01), diminished Nrf2 fluorescence intensity in the myocardial tissue, and downregulated expression levels of Nrf2, SLC7A11, and GPX4 (P<0.01). Compared with the model group, Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma reduced the LVEDD, LVESD, and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.05, P<0.01), increased the LVEF and LVFS (P<0.05, P<0.01), alleviated pathological changes such as myocardial cell disarrangement, inflammatory cell infiltration, myocardial fibrosis, and iron deposition, lowered the level of MDA (P<0.05, P<0.01), raised the level of GSH (P<0.05, P<0.01), improved the mitochondrial morphology and reduced vacuolation in the myocardial tissue, enhanced Nrf2 fluorescence intensity, and upregulated the expression levels of Nrf2, SLC7A11, and GPX4 (P<0.05, P<0.01) in the rat model of myocardial infarction. ConclusionGardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma alleviates pathological damage and myocardial remodeling in the rat model of myocardial infarction by inhibiting ferroptosis, the mechanism of which is related to the activation of Nrf2/SLC7A11/GPX4 signaling pathway.
4.Thrombus Migration After Tenecteplase Versus Alteplase in Acute Large Vessel Occlusion
Lu WANG ; Fuxia YANG ; Xiao WU ; Lulan LI ; Xueqiao JIAO ; Fangfang ZHANG ; Fengyuan CHE ; Hongxing HAN ; Weidong LIU ; Peifu WANG ; Xuesong LI ; Junfeng SHI ; Jia LIU ; Xunming JI ; Xiuhai GUO
Journal of Stroke 2026;28(2):283-292
Background:
and Purpose In patients with large vessel occlusion (LVO), intravenous thrombolysis (IVT) frequently alters thrombus location; however, the clinical impact of this phenomenon remains unclear. We aimed to compare post-IVT thrombus dynamics between tenecteplase and alteplase and to evaluate the association between thrombus dynamics and 3-month outcomes.
Methods:
This retrospective study analyzed prospectively collected, multicenter data from consecutive patients with LVO who underwent bridging therapy between January 2022 and December 2024. Thrombus dynamics were classified as resolution, migration, or stability. Analyses incorporated propensity score matching with weighting to balance baseline characteristics.
Results:
Of the 806 initially included patients, 746 were included after matching (373 treated with tenecteplase and 373 treated with alteplase). The incidence of thrombus migration was significantly higher in the tenecteplase group than in the alteplase group (19.3% vs. 11.3%; odds ratio [OR]: 1.92; 95% confidence interval [CI] 1.27–2.91). The advantage of tenecteplase over alteplase was restricted to patients with an IVT-to-puncture time of <60 minutes (18.6% vs. 6.2%; p=0.001) and was no longer significant when the interval ≥60 minutes (19.7% vs. 15.0%; p=0.204; pinteraction=0.043). Additionally, thrombus migration was associated with a better functional outcome (OR: 1.62; 95% CI 1.04–2.53). Finally, tenecteplase was associated with improved functional independence compared with alteplase (OR: 1.43; 95% CI 1.04–1.95).
Conclusions
Tenecteplase demonstrated superior efficacy in inducing thrombus migration compared with alteplase, particularly within 60 minutes of IVT administration. Thrombus migration independently predicted improved functional independence. These findings support the preferential use of tenecteplase for bridging therapy in patients with LVO.
5.Qualitative research on issues related to the welfare protection of animals after medical experiments
Jiayi PAN ; Xuesong WU ; Yu WANG ; Xiaojun CAI
Chinese Medical Ethics 2026;39(8):1005-1012
In-depth interviews were conducted with medical doctoral students engaged in animal experiments, animal laboratory management personnel, and ethics committee members, exploring the current status, challenges, and countermeasures regarding animal welfare protection after medical experiments based on NVivo 12 software. The study found that some laboratory animals still meet the conditions for continued breeding after the experiments, but face multiple challenges such as physiological health, psychological stress, adoption and placement, as well as ethical and legal issues. On this basis, this paper proposed countermeasures such as establishing adoption mechanisms, enhancing public awareness, and improving the ethical review system. This aimed to achieve a balance between the development of medical science and animal welfare, thereby ensuring that laboratory animals receive due respect and care after contributing to the cause of human health.
6.Dilemmas and optimization strategies of scientific research integrity governance in China from the perspective of policy evolution (2004-2025)
Jiena CHEN ; Rongqing SHAO ; Xuesong WU ; Yu WANG ; Xiaojun CAI
Chinese Medical Ethics 2026;39(10):1314-1321
ObjectiveTo systematically analyze the evolution characteristics and practical dilemmas of China’s scientific research integrity policies from 2004 to 2025, and to provide a reference for improving the governance system of science and technology ethics. MethodsBased on 53 policy documents retrieved from authoritative sources, such as the State Council policy document database, this study employed a three-stage coding process with NVivo 14, combined with word frequency analysis and policy metrology. ResultsThe policy evolution progressed through three phases regarding “partial exploration, system construction, and technological governance.” It demonstrated three characteristics, including systematic top-level design, rigid disciplinary mechanisms, and technologized supervision means. Nevertheless, the current governance system was still confronted with dilemmas such as biased institutional incentives, insufficient deterrence of disciplinary measures, and lagging technological supervision means. ConclusionThe study attempts to build a closed-loop governance paradigm of “institution-technology-culture,” deepen institutional reform to rectify incentive biases, adopt technology empowerment to promote full-process evidence preservation, and reshape academic culture to foster conscious integrity. This can systematically solve the problems of scientific research integrity anomie, thereby providing strong support for the high-quality development of scientific and technological innovation and the improvement of human well-being.
7.Analysis of results of radiation detection capability intercomparison between disease control and prevention institutions at provincial, municpal and county levels in China from 2022 to 2024
Peize TANG ; Xiaorui WANG ; Zhu YAO ; Hua ZHAO ; Pin GAO ; Tianjiao JIA ; Kaiyi WANG ; Xuesong QI
Chinese Journal of Radiological Medicine and Protection 2025;45(8):724-730
Objective:To analyze the intercomparision result of personal dose monitoring and gross alpha/beta detection capability between the disease control and prevention institutions at provincial, municpal and county levels during 2022-2024, in order to provide a reference for radiation detection capability and policy making of these institutions in China.Methods:Data on personal dose monitoring and gross alpha/beta detection, obtanied from the 2022-2024 radiation detection capability intercomparison between the disease control and prevention institutions at different levels, were recorded. Both the qualification rates (including excellence) and excellence rates of all the institutions at all evels from 2022 to 2024 were analyzed using SPSS 22.0.Results:From 2022 to 2024, the number of participating institutions at all levels showed an overall upward trend, increasing from 262 to 430, with particularly notable growth at the municipal level. In the 2024 gross α/β detection capability intercomparison, the non-qualification rate in municipal-level institutions was significantly higher than in county-level institutions ( χ2=10.53, P < 0.05). The qualification rate (including excellence) of the municipal-level gross alpha/beta detection in 2022 and 2024 were lower than in 2023( χ2=29.93, P < 0.01). Among all regions, the 2024 personal dose monitoring intercomparison result showed that the qualification rate (including excellence) in East China was higher than in Southwest and Northwest China ( χ2=15.62, P <0.01). East China also outperformed Northwest China ( χ2=16.21, P <0.01). In the 2022 gross alpha/beta detection capability intercomparison, the qualification rate (including excellent performance) in East China and South China was higher than in Northwest China ( χ2=23.76, 11.22, P<0.01). Overall, East China showed relatively higher qualification rate in intercomparison result of both personal dose monitoring and radiation detection (including excellence), while Northwest China showed lower qualification rates (including excellence). Conclusions:Although the radiation detection capability of disease control and prevention institutions at all levels has improved in recent years, there are still insufficience of detection capabilities at some municipal- and county-level laboratories and even unbalance between different regionas. Policy support should prioritize underdeveloped areas, such as municipal- and county-level institutions and the Northwest, and enhance the technical proficiency and quality management of laboratory personnel.
8.Analysis of medical cases and medication patterns for multiple system atrophy-orthostatic hypotension
Xuelian ZHAO ; Shaoqing WANG ; Tao YANG ; Xuesong ZHAO
China Modern Doctor 2025;63(18):59-63
Objective Using the Traditional Chinese Medicine Inheritance Assistance Platform V2.5 software,to analyze medical cases and prescription medication patterns of multiple system atrophy-orthostatic hypotension,and provide reference for clinical diagnosis and treatment of multiple system atrophy.Methods Relevant literature on the effectiveness of traditional Chinese medicine in treating multiple system atrophy-orthostatic hypotension was collected from China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,Chinese Medical Journal Full Text Database,and China Biomedical Literature Database.A database of medical cases and prescriptions was established on the Traditional Chinese Medicine Inheritance Assistance Platform.The software used mathematical algorithms based on association rules and entropy clustering to analyze the symptom ranking,symptom patterns,symptom clustering,and network display of medical cases,as well as the properties,taste,meridian tropism,frequency of application,and drug pair combinations of drugs in prescriptions.The core drugs were identified and the rules of diagnosis and treatment were explored.Results Through the Traditional Chinese Medicine Inheritance Assistance Platform V2.5 software,47 medical cases of multiple system atrophy were analyzed,including 73 symptoms.Among them,there were 8 symptoms with a frequency of ≥5,among which the most frequent symptom was pulse sinking,which appeared 8 times.And included 11 syndromes,the most frequent symptom was insufficient Qi syndrome,which appeared 12 times.The drug symptom network diagram,drug symptom network diagram,and drug symptom network diagram of multiple system atrophy-orthostatic hypotension medical cases were also drawn,which is the first time in the study.There are a total of 47 prescriptions for multiple system atrophy,including 106 types of drugs.Through analysis,the drugs used are mainly warm,cold,and flat,with less use of hot and cool drugs.The flavors are mainly sweet,spicy,and bitter,and the meridian tropism is mainly focused on the spleen,lungs,liver,heart,kidneys,and stomach.The top 10 drugs with the highest frequency of occurrence are Huangqi,Danggui,Shengma,Baizhu,Dangshen,Chenpi,Renshen,Chaihu,Fuzi,and Zhigancao.Among them,Huangqi has the highest frequency of occurrence,appearing 31 times,and has evolved into 66 core combinations of drugs and 3 new formulas.Conclusion The objective display of the medical case characteristics and medication features of multiple system atrophy-orthostatic hypotension through data mining has certain guiding significance for the research and clinical medication of this disease.
9.Influencing factors of health-related quality of life in patients after ileal ureteral replacement:a qualitative study
Yan WANG ; Hua GUAN ; Zhihua LI ; Xuesong LI ; Dong PANG
Chinese Journal of Nursing 2025;60(14):1736-1742
Objective To explore the influencing factors of health-related quality of life in patients after ileal ureteral replacement,and to provide a reference for formulating effective management plans.Methods Based on the conceptual model of health-related quality of life,16 patients who underwent ileal ureteral replacement in the Department of Urology of a tertiary A hospital in Beijing were selected for semi-structured interviews using descriptive research methods and purposive sampling method.The data were analyzed using directed content analysis.Results There are 6 themes and 10 sub-themes:symptom factors(distress of tube-related symptoms,distress of gastrointestinal symptoms);individual characteristics factors(obvious negative emotions,health behavior development);environmental factors(support from relatives and colleagues,lack of primary medical services);functional status factors(physical function rehabilitation,social function recovery);physiological function factors(test abnormal test index,risk of primary disease recurrence);general health perception factors.Conclusion The health-related quality of life of patients undergoing ileal ureteral replacement surgery was affected by symptoms,negative emotions,health behaviors,social support,functional status et al.In view of the above factors,medical staff should carry out effective evaluation and intervention in time,so as to improve the quality of life of patients.
10.Mendelian randomization study on the relationship between thyroid dysfunction and insomnia
Xuelian ZHAO ; Shaoqing WANG ; Tao YANG ; Xuesong ZHAO
China Modern Doctor 2025;63(19):70-75
Objective Two-sample Mendelian randomization(MR)analysis was used to explore the causal relationship between hyperthyroidism/hypothyroidism and insomnia.Methods A two-sample MR method was adopted.The exposure factors were hyperthyroidism/hypothyroidism,and the outcome was insomnia.The instrumental variables were screened.Inverse variance weighting(IVW)was mainly used to analyze the causal relationship between hyperthyroidism/hypothyroidism and insomnia.Meanwhile,MR-Egger,weighted mode,weighted median,and simple mode were used to supplement the IVW analysis results.Cochran's Q test was used to determine the statistical heterogeneity among single nucleotide polymorphism(SNP),and the intercept term of MR-Egger was used to evaluate whether SNP had horizontal pleomorphism.The influence of a single SNP on the IVW analysis results was evaluated by the retention of one method.To avoid reverse causality,insomnia was taken as the exposure factor and hyperthyroidism/hypothyroidism as the outcome event for reverse MR analysis.Results A total of 11 SNP strongly related to hyperthyroidism were screened out.After eliminating the palindromic sequences,9 SNP strongly related to hyperthyroidism were finally included.The IVW analysis results showed that hyperthyroidism increased the risk of insomnia(OR=1.01,95%CI:1.00-1.01,P=0.012).A total of 68 SNP strongly related to hypothyroidism were screened out.After removing the palindromic sequences,61 SNP highly related to hypothyroidism were finally included.The IVW analysis results showed that hypothyroidism increased the risk of insomnia(OR=1.01,95%CI:1.00-1.01,P=0.021).The results of Cochran's Q test showed that there was no heterogeneity in the instrumental variable hyperthyroidism(P=0.60).The MR-Egger intercept analysis indicated that studies with hyperthyroidism/hypothyroidism as exposure and insomnia as the outcome did not have horizontal pleiotropy(P>0.05).Reverse MR analysis revealed that exposure factors such as insomnia had no causal relationship with hyperthyroidism(OR=1.57,95%CI:0.55-4.50,P=0.40)or hypothyroidism(OR=1.09,95%CI:0.74-1.61,P=0.66).Conclusion Hyperthyroidism/hypothyroidism can increase the risk of insomnia.

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