1.Principles, technical specifications, and clinical application of lung watershed topography map 2.0: A thoracic surgery expert consensus (2024 version)
Wenzhao ZHONG ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Wei JIANG ; Deping ZHAO ; Hecheng LI ; Xiaolong YAN ; Lijie TAN ; Junqiang FAN ; Guibin QIAO ; Qiang NIE ; Mingqiang KANG ; Weibing WU ; Hao ZHANG ; Zhigang LI ; Zihao CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):141-152
With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.
2.The risk prediction models for anastomotic leakage after esophagectomy: A systematic review and meta-analysis
Yushuang SU ; Yan LI ; Hong GAO ; Zaichun PU ; Juan CHEN ; Mengting LIU ; Yaxie HE ; Bin HE ; Qin YANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):230-236
Objective To systematically evaluate the risk prediction models for anastomotic leakage (AL) in patients with esophageal cancer after surgery. Methods A computer-based search of PubMed, EMbase, Web of Science, Cochrane Library, Chinese Medical Journal Full-text Database, VIP, Wanfang, SinoMed and CNKI was conducted to collect studies on postoperative AL risk prediction model for esophageal cancer from their inception to October 1st, 2023. PROBAST tool was employed to evaluate the bias risk and applicability of the model, and Stata 15 software was utilized for meta-analysis. Results A total of 19 literatures were included covering 25 AL risk prediction models and 7373 patients. The area under the receiver operating characteristic curve (AUC) was 0.670-0.960. Among them, 23 prediction models had a good prediction performance (AUC>0.7); 13 models were tested for calibration of the model; 1 model was externally validated, and 10 models were internally validated. Meta-analysis showed that hypoproteinemia (OR=9.362), postoperative pulmonary complications (OR=7.427), poor incision healing (OR=5.330), anastomosis type (OR=2.965), preoperative history of thoracoabdominal surgery (OR=3.181), preoperative diabetes mellitus (OR=2.445), preoperative cardiovascular disease (OR=3.260), preoperative neoadjuvant therapy (OR=2.977), preoperative respiratory disease (OR=4.744), surgery method (OR=4.312), American Society of Anesthesiologists score (OR=2.424) were predictors for AL after esophageal cancer surgery. Conclusion At present, the prediction model of AL risk in patients with esophageal cancer after surgery is in the development stage, and the overall research quality needs to be improved.
3.Mechanism of Paeonol in Alleviating Alcohol-induced Liver Injury in Mice Through Regulating SCFAs-GPR43/MAPK Signaling Pathway Mediated by Intestinal Flora
Shengnan JIANG ; Qifeng WU ; Zining WANG ; Hao PU ; Guiming YAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):129-139
ObjectiveTo investigate the ameliorative effect of paeonol on acute alcohol-induced hepatic inflammation in mice via the regulation of the short-chain fatty acids (SCFAs)-specific receptor GPR43/mitogen-activated protein kinase (MAPK) signaling pathway. MethodsC57BL/6 mice were randomly divided into five groups: blank control group, model group, low-dose paeonol group (120 mg·kg-1), high-dose paeonol group (480 mg·kg-1), and silybin group (36.8 mg·kg-1). A mouse model of alcohol-induced liver disease (ALD) was established by ad libitum administration of a Lieber-DeCarli alcohol liquid diet. Serum lipid levels, liver function, inflammatory cytokines, and oxidative stress markers were measured. Liver hematoxylin-eosin (HE) staining and Oil Red O staining were performed to validate successful modeling. Western blot analysis was used to assess the expression levels of zonula occludens-1 (ZO-1), Claudin-1, and proteins related to the GPR43/MAPK signaling pathway in the colonic tissue. Immunohistochemistry was employed to detect the protein expression of GPR43, ZO-1, and Claudin-1 in the colon. Then 16S rDNA sequencing was performed to analyze differences in intestinal flora between the model group and the high-dose paeonol group. Additionally, fecal microbiota transplantation (FMT) experiments were conducted to validate the regulatory effect of paeonol on ALD via modulation of intestinal flora. ResultsCompared with the blank control group, the model group showed significantly elevated serum lipid levels, oxidative stress, and inflammatory cytokine expression (P<0.01). Liver histology revealed increased inflammatory infiltration and lipid droplet accumulation. Colonic mucosal injury and impaired intestinal barrier function were observed. Levels of MAPK pathway-related proteins in the colonic tissue were upregulated (P<0.01), while GPR43, ZO-1, and Claudin-1 protein expression levels were significantly decreased (P<0.01). The composition and abundance of the intestinal flora were markedly altered, with a reduced Bacteroidetes-to-Firmicutes ratio and decreased relative abundances of Eubacterium, Parabacteroides, Erysipelothrix, and Adlercreutzia, alongside increased abundances of Clostridium butyricum, Enterococcus, and Helicobacter pylori in the model group. Compared with the model group, paeonol significantly reduced serum lipid levels, oxidative stress responses, and the expression of inflammatory cytokines in ALD mice (P<0.05, P<0.01). It also attenuated hepatic lipid accumulation, restored intestinal barrier function, and repaired the structural integrity of liver and colonic tissues. The protein expression levels of ZO-1, Claudin-1, and GPR43 in the colonic tissue were significantly increased (P<0.05, P<0.01), while those of MAPK pathway-related proteins were significantly decreased (P<0.05, P<0.01). The intestinal flora dysbiosis was effectively alleviated, rendering its composition closer to that of normal mice. The efficacy of paeonol in modulating ALD was further confirmed by FMT experiments, supporting its mechanistic involvement in the SCFAs-GPR43/MAPK signaling pathway. ConclusionPaeonol exerts a protective effect against ALD in mice, which may be mediated through regulation of the SCFAs-GPR43/MAPK signaling pathway, thereby achieving anti-inflammatory effects and improving intestinal barrier function.
4.Mechanism of Paeonol in Alleviating Alcohol-induced Liver Injury in Mice Through Regulating SCFAs-GPR43/MAPK Signaling Pathway Mediated by Intestinal Flora
Shengnan JIANG ; Qifeng WU ; Zining WANG ; Hao PU ; Guiming YAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):129-139
ObjectiveTo investigate the ameliorative effect of paeonol on acute alcohol-induced hepatic inflammation in mice via the regulation of the short-chain fatty acids (SCFAs)-specific receptor GPR43/mitogen-activated protein kinase (MAPK) signaling pathway. MethodsC57BL/6 mice were randomly divided into five groups: blank control group, model group, low-dose paeonol group (120 mg·kg-1), high-dose paeonol group (480 mg·kg-1), and silybin group (36.8 mg·kg-1). A mouse model of alcohol-induced liver disease (ALD) was established by ad libitum administration of a Lieber-DeCarli alcohol liquid diet. Serum lipid levels, liver function, inflammatory cytokines, and oxidative stress markers were measured. Liver hematoxylin-eosin (HE) staining and Oil Red O staining were performed to validate successful modeling. Western blot analysis was used to assess the expression levels of zonula occludens-1 (ZO-1), Claudin-1, and proteins related to the GPR43/MAPK signaling pathway in the colonic tissue. Immunohistochemistry was employed to detect the protein expression of GPR43, ZO-1, and Claudin-1 in the colon. Then 16S rDNA sequencing was performed to analyze differences in intestinal flora between the model group and the high-dose paeonol group. Additionally, fecal microbiota transplantation (FMT) experiments were conducted to validate the regulatory effect of paeonol on ALD via modulation of intestinal flora. ResultsCompared with the blank control group, the model group showed significantly elevated serum lipid levels, oxidative stress, and inflammatory cytokine expression (P<0.01). Liver histology revealed increased inflammatory infiltration and lipid droplet accumulation. Colonic mucosal injury and impaired intestinal barrier function were observed. Levels of MAPK pathway-related proteins in the colonic tissue were upregulated (P<0.01), while GPR43, ZO-1, and Claudin-1 protein expression levels were significantly decreased (P<0.01). The composition and abundance of the intestinal flora were markedly altered, with a reduced Bacteroidetes-to-Firmicutes ratio and decreased relative abundances of Eubacterium, Parabacteroides, Erysipelothrix, and Adlercreutzia, alongside increased abundances of Clostridium butyricum, Enterococcus, and Helicobacter pylori in the model group. Compared with the model group, paeonol significantly reduced serum lipid levels, oxidative stress responses, and the expression of inflammatory cytokines in ALD mice (P<0.05, P<0.01). It also attenuated hepatic lipid accumulation, restored intestinal barrier function, and repaired the structural integrity of liver and colonic tissues. The protein expression levels of ZO-1, Claudin-1, and GPR43 in the colonic tissue were significantly increased (P<0.05, P<0.01), while those of MAPK pathway-related proteins were significantly decreased (P<0.05, P<0.01). The intestinal flora dysbiosis was effectively alleviated, rendering its composition closer to that of normal mice. The efficacy of paeonol in modulating ALD was further confirmed by FMT experiments, supporting its mechanistic involvement in the SCFAs-GPR43/MAPK signaling pathway. ConclusionPaeonol exerts a protective effect against ALD in mice, which may be mediated through regulation of the SCFAs-GPR43/MAPK signaling pathway, thereby achieving anti-inflammatory effects and improving intestinal barrier function.
5.Study on the correlation between hyperopia reserve and ocular biometric parameters after ciliary muscle paralysis in 4-14 year-old students from Hotan County, Xinjiang
Ning LI ; Yan WANG ; Lei YANG ; Qian PU ; AYINU·NULAHOU ; Xiaolong LI ; Yong ZHAO ; Yunxian GAO
International Eye Science 2025;25(8):1371-1376
AIM: To explore the relationship between hyperopia reserve and ocular biometric parameters in 4-14 year-old Uyghur students from Hotan County, Xinjiang, and to provide scientific evidence for myopia prevention.METHODS: From September 1 to October 31, 2023, a stratified random cluster sampling method was used to select 3 264 students(3 264 eyes)from 6 schools in Hotan County. Participants underwent uncorrected distance visual acuity testing, cycloplegic refraction, and ocular biometric measurements. The correlation between spherical equivalent(SE)and ocular biometric parameters was analyzed by multiple linear regression.RESULTS: A total of 1 998 non-myopic students(1 998 eyes)were included in the study, with 1 354 students(67.77%)showing insufficient hyperopia reserve. The detection rate of insufficient hyperopia reserve decreased with age, from 94.12% at age 4 to 18.13% at age 14(P<0.001). Multiple linear regression analysis showed that in the group with sufficient hyperopia reserve, age, gender, uncorrected distance visual acuity, axial length(AL), and keratometry(K)explained 66.5% of the variance in SE; while in the group with insufficient hyperopia reserve, these factors explained only 28.0% of the SE variance.CONCLUSION: In non-myopic Uyghur students aged 4-14 in Hotan County, Xinjiang, the detection rate of insufficient hyperopia reserve was 67.77%. In the group with insufficient hyperopia reserve, age, gender, AL, and K explained only a small portion of the SE variance, suggesting that the refractive status of this population may be influenced by more complex factors.
6.Case analysis of occupational disease diagnosis appraisal in Shanghai from 2012 to 2024
Ran ZHUANG ; Tingting DOU ; Jing QU ; Tongning GAO ; Lili PU ; Yan YIN
Journal of Environmental and Occupational Medicine 2025;42(7):822-826
Background Occupational disease diagnosis appraisal is an appeal procedure initiated when a party disagrees with the occupational disease diagnosis conclusion. It is a legal procedure to safeguard the health rights of employees and the legitimate rights and interests of employers. Objective To analyze the data of occupational disease diagnosis appraisal in Shanghai, identify existing problems, and provide suggestions for improving. Methods Statistical analysis was conducted on basic situation, characteristics of workers and employers, disease classification, and consistency between diagnosis and appraisal conclusions of all occupational disease diagnosis appraisal cases from 2012 to 2024. All diagnosis conclusions were named in accordance with the Classified Catalogue of Occupational Diseases included employers were classified according to the Measures for the Statistical Classification of Large, Medium, Small and Micro Enterprises" and the Notice on Adjusting the Provisions for Classifying Enterprise Registration Types; industry classification followed the Industrial Classification for National Economic Activities (GB/T 4754-2017). Results From 2012 to 2024, a total of 260 cases of occupational diseases diagnosis appraisal were closed. The main diagnosis were 138 cases of ear, nose, throat, and oral diseases (53.1%), chemical poisoning (18.8%), and pneumoconiosis and other respiratory diseases (16.2%). The proportion of ear, nose, throat, and oral diseases gradually increased (2022 excluded). The incidence of annual municipal and provincial cases decreased by 76.3% and 85.0% respectively (2024 vs 2012). The consistency rate of conclusions between appraisal and diagnosis gradually increased. The total consistency rates between final appraisals and diagnostic conclusions were 81.5%, and 79.7%, 87.8%, 100.0%, 85.0% for ear, nose, throat, and oral diseases, chemical poisoning, and pneumoconiosis and other respiratory system diseases, respectively. Specifically, the consistency rates were 80.1% and 80.0% for noise-induced deafness and chronic benzene poisoning. In terms of inconsistency reasons, "inconsistent interpretation of standards and excessive discretion in standard application" accounted for 43.8%, followed by "failure to correctly apply standards" (31.3%) and and "discrepancies in occupational exposure history recognition" (15.6%). Conclusion The revisions and improvements of the legal system for occupational disease diagnosis appraisal have played a positive role in improving the consistency of conclusions between appraisal and diagnosis of occupational diseases in Shanghai. It is suggested to further strengthening the publicity and training of occupational disease diagnosis standards to improve the quality of occupational disease diagnosis.
7.Yunpi Huatan Tongqiao Prescription Regulates Microglial Cell Polarization Phenotype to Improve Inflammation and Cognitive Impairment in OSA Mice by Down-regulating Glycolysis
Wenyan PU ; Anqi LIU ; Yan LIN ; Xuejun LI ; Hongyu ZHANG ; Zhiyan JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):35-42
ObjectiveTo validate the efficacy of Yunpi Huatan Tongqiao prescription (YHTP) in down-regulating glycolysis to modulate microglia phenotype and improve inflammation and cognitive memory deficits in obstructive sleep apnea (OSA) mice. MethodForty-eight male Balb/C mice were randomly divided into a normal group, a model group, a montelukast sodium group (30 mg·kg-1), and low, medium, and high dose groups of YHTP (8.28, 16.56, and 33.12 g·kg-1), with 8 mice in each group. All groups, except the normal group, received intraperitoneal injections of lipopolysaccharide (LPS) and underwent chronic intermittent hypoxia (CIH) modeling for 4 weeks. Subsequently, the mice were treated with medications for 4 weeks and then sampled. Animal behavioral tests assessed memory impairment due to hypoxia. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to measure mRNA expression levels of M1-associated inflammatory factors interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and markers such as T lymphocyte activation antigen (CD86) and inducible nitric oxide synthase (iNOS), as well as M2-associated inflammatory factors interleukin-10 (IL-10), transforming growth factor-β (TGF-β), and the marker mannose receptor (CD206) in hippocampal tissue. Western blot was employed to detect differences in the expression of M1 and M2 microglia phenotypic markers (CD86, CD206) and glycolysis-related proteins glucose transporter type 1 (GLUT1), hexokinase 2 (HK2), phosphofructokinase (PFKM), pyruvate kinase 2 (PKM2), and monocarboxylic acid transporter 1 (MCT1). ResultBehavioral tests showed that compared to the results in the normal group, the Y-maze autonomous alternation rate was significantly reduced in the model group (P<0.01). The latency time for the target hole in the Barnes' maze during the training period (days 2, 3, 4) and testing period (days 5, 12) was significantly increased (P<0.05, P<0.01). M1 glial cell markers CD86 and iNOS, as well as inflammatory factors IL-1β and TNF-α mRNA, were significantly elevated (P<0.01). In contrast, the mRNA expression of M2 glial cell markers IL-10, CD206, and TGF-β was significantly reduced (P<0.01). The protein expression of glycolytic proteins HK2, PFKM, PKM2, MCT1, and the M1 marker CD86 was significantly increased (P<0.05, P<0.01), while M2 marker CD206 protein expression was significantly decreased (P<0.01). Compared to the results in the model group, the Y-maze autonomous alternation rate was significantly increased in the medium and high dose groups of YHTP (P<0.05, P<0.01). The latency time for the target hole during the training (day 4) and testing periods (days 5, 12) was significantly reduced (P<0.01). Real-time PCR results indicated that mRNA expression levels of M1-related pro-inflammatory factors in the hippocampal tissue were significantly reduced in the low, medium, and high dose groups of YHTP (P<0.01), while M2-related inflammatory factors' mRNA expression was significantly increased (P<0.01). Western blot results showed that in the medium and high dose groups of YHTP, the expression of the M1 marker CD86 in the hippocampus was reduced, whereas the expression of the M2 marker CD206 was significantly increased (P<0.01), with a significant decrease in the expression of glycolysis-related proteins (P<0.01). ConclusionYHTP can improve inflammation and cognitive impairment induced by hypoxia in OSA model mice. This is achieved by downregulating glycolysis in brain microglia, inhibiting M1 activation, reducing pro-inflammatory factor release, and promoting M2 activation, thereby exerting a therapeutic effect on inflammation and cognitive impairment caused by OSA.
8.Research on species identification of commercial medicinal and food homology scented herbal tea
Jing SUN ; Zi-yi HUANG ; Si-qi LI ; Yu-fang LI ; Yan HU ; Shi-wen GUO ; Ge HU ; Chuan-pu SHEN ; Fu-rong YANG ; Yu-lin LIN ; Tian-yi XIN ; Xiang-dong PU
Acta Pharmaceutica Sinica 2024;59(9):2612-2624
The adulteration and counterfeiting of herbal ingredients in medicinal and food homology (MFH) have a serious impact on the quality of herbal materials, thereby endangering human health. Compared to pharmaceutical drugs, health products derived from traditional Chinese medicine (TCM) are more easily accessible and closely integrated into consumers' daily life. However, the authentication of the authenticity of TCM ingredients in MFH has not received sufficient attention. The lack of clear standards emphasizes the necessity of conducting systematic research in this area. This study utilized DNA barcoding technology, combining ITS2,
9.Research progress in regulation and mechanism of transcription factors on tanshinones
Yan-hong BAI ; Lin-lin XIN ; Ting ZENG ; Feng-xia HAN ; Yong-qing ZHANG ; Gao-bin PU ; Xue CHEN ; Qian LIU
Acta Pharmaceutica Sinica 2024;59(5):1218-1228
italic>Salvia miltiorrhiza, a commonly used traditional Chinese medicine, has been widely recognized for its blood-activating and stasis-removing properties in the clinical treatment of cardiovascular and cerebrovascular diseases. The synthesis and regulatory mechanism of tanshinones, the key active constituents of
10.Analysis of phenotype formation mechanism of a new variety of Lonicera japonica Flos "Huajin 6" at long bud stage
Run-zhu LI ; Cong-lian LIANG ; Zhen-hua LIU ; Jia LI ; Yong-qing ZHANG ; Hai-yan LIU ; Gao-bin PU
Acta Pharmaceutica Sinica 2024;59(2):476-481
Based on the long bud stage phenotype of a new

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