1.Five Principles for the Development of Oncology Critical Care Medicine
Zhengheng YU ; Zeyu ZHANG ; Yanli YANG
Medical Journal of Peking Union Medical College Hospital 2026;17(1):10-15
With the deep integration of tumor diagnosis and treatment technologies and critical care medicine, oncology critical care has emerged as an innovative interdisciplinary field, whose standardized development is crucial for improving the prognosis of cancer patients. Based on complex system theory and incorporating cutting-edge clinical practices, this paper systematically elaborates on five core principles for promoting the high-quality development of oncology critical care: complex system thinking, value-based healthcare, interdisciplinary integration, spatiotemporal holism, and humanistic experience. These five principles provide a top-level design framework for the discipline in terms of conceptual understanding, comprehensive management, developmental paradigms, clinical treatment, and service models. They aim to establish a patient-centered oncology critical care system that balances medical quality and efficiency, ultimately maximizing patient survival benefits across their entire life cycle.
2.Research on dynamic monitoring of drug consumption based on seasonal Mann-Kendall trend test
Ziheng YU ; Chen CHEN ; Xiangyu YANG ; Lulu LI ; Shaohui ZHANG
China Pharmacy 2026;37(3):377-382
OBJECTIVE To investigate a dynamic monitoring of drug consumption (DMDC) model based on the seasonal Mann-Kendall trend test, aiming to provide scientific evidence for the efficient and macroscopic monitoring of drug use. METHODS A monitoring list of key outpatient drugs was established based on the top 20% of drugs ranked by sales volume in the outpatient pharmacy in October 2024. A DMDC model based on the Mann-Kendall trend test was constructed using the monthly usage data of key outpatient drugs from November 2021 to October 2024, aiming to eliminate the impact of seasonal fluctuations and analyze the temporal trends in drug consumption. Taking mucolytic expectorants, triazole derivatives for dermatophytosis, and single-agent hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors as examples, the monitoring effectiveness of the DMDC model was demonstrated, and its performance was compared with that achieved by the traditional sequential growth rate ranking method. RESULTS A total of 215 drug varieties were included in the monitoring list, and DMDC models were successfully established for all of them. Among these, 119 showed a significant increasing trend (P<0.05, S′>0). The model successfully monitored the monthly consumption of mucolytic expectorants, triazole derivatives for dermatophytosis, and single- agent HMG-CoA reductase inhibitors. The precision and recall rates of the DMDC model for identifying abnormal drug use were 60.7% and 85.0%, respectively, both significantly higher than those of the sequential growth rate ranking method (8.3% and 15.0%, respectively) (χ2=20.114, P<0.001; χ2=19.600, P<0.001). CONCLUSIONS DMDC model based on the seasonal Mann-Kendall trend test can effectively identify long-term trends in drug consumption, eliminate seasonal interference, enhance monitoring accuracy and management efficiency, and is suitable for the dynamic monitoring of drug consumption.
3.Analysis of the impact of intraoperative RhE antigen-matched transfusion on early prognosis in liver transplant patients
Xiaochao YU ; Xinyuan GAO ; Fan HAI ; Chao YANG ; Xingyu HOU ; Yaping XING ; Hongqiang GAO ; Hongwei ZHANG ; Gang SU ; Ronghua XU
Chinese Journal of Blood Transfusion 2026;39(1):44-50
Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ
=4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.
4.Study on the compatibility stability of 16 commonly used intravenous antibiotics in ICU
Liting ZHANG ; Haotian YANG ; Siqi YU ; Liju FAN ; Jing AN
China Pharmacy 2026;37(4):468-475
OBJECTIVE To systematically analyze the compatibility stability of commonly used intravenous antibiotics in the intensive care unit (ICU), and to provide evidence-based support for rational clinical drug use. METHODS Medication data from the ICU of Hebei General Hospital between January and December 2024 were extracted from the Prescription Automatic Screening System. Commonly used intravenous antibiotics and other intravenous drugs in the ICU were selected through consultations with critical care and pharmacy experts in Hebei province, drug package inserts and compatibility information retrieved from Micromedex, Trissel’s Injectable Drug Handbook and PubMed. The physicochemical stability of drug combinations was analyzed. In addition, Cytoscape 3.10.2 software was used to construct a drug compatibility network for identifying high-risk drugs. RESULTS &CONCLUSIONS A total of 904 pairwise drug combinations involving 16 antibacterial agents and 65 intravenous drugs were collected. Among them, 549 combinations (60.7%) were compatible, 88 combinations (9.7%) were incompatible, 82 combinations (9.1%) had conflicting evidence, and 185 combinations (20.5%) lacked valid data support. High-risk combination drugs primarily involved Amphotericin B for injection, Ceftazidime for injection, Imipenem-cilastatin for injection, Ceftriaxone sodium for injection, Vancomycin hydrochloride for injection, etc. The main risk factors for drug-drug incompatibility included drug concentration, temperature, mixing rate, pH, and chemical structure. In clinical practice, drugs and diluents should be selected rationally based on specific compatibility data, and research and monitoring of drug compatibility should be further strengthened.
5.Herbal Textual Research on Bambusae Succus in Famous Classical Formulas
Yu SHI ; Feng ZHOU ; Yihan WANG ; Yanmeng LIU ; Ming YANG ; Zhiping CHEN ; Jiangshan ZHANG ; Conglong XU ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):231-239
This article systematically reviews and examines the historical evolution of Bambusae Succus as a medicinal material, covering aspects such as nomenclature, origin, geographical distribution, harvesting and processing methods, quality assessment, therapeutic effects and indications, by consulting ancient herbal texts, medical compendia, and modern literature. The aim is to provide a reference for the development and utilization of famous classical formulas containing this herb. Research indicated that Bambusae Succus was first documented in the Shennong Bencaojing during the Han dynasty, with Zhuli being the standard name used throughout history, alongside aliases like Zhuzhi, Zhuyou and Huoquan. Historically, the primary source of Bambusae Succus has been Phyllostachys nigra var. henonis(Danzhu), although other species such as Pleioblastus amarus and Bambusa emeiensis have also been used medicinally. Ancient records predominantly noted its origin in Yizhou(present-day Chengdu and surrounding areas in Sichuan) and the Wuling region(between present-day Hunan, Guangdong, Guangxi and Jiangxi provinces), while contemporary sources are mainly from regions south of the Yangtze River and southwestern China. Traditionally, Bambusae Succus was harvested from bamboo that had grown for exactly one year, today, it can be collected year-round without strict age requirements. Ancient preparation methods included direct fire roasting or dry distillation, whereas modern industrial production employs dry distillation, reflux extraction, and percolation. In terms of quality evaluation, ancient texts considered a sweet taste to be superior, while today, clarity and transparency are prioritized. Historically, Bambusae Succus was characterized as sweet and cold nature, targeting the lung and stomach meridians, with uses evolving from clearing heat and resolving phlegm to nourishing Yin, moistening dryness, and relaxing tendons and unblocking meridians. Modern descriptions classify it as sweet, bitter, and cold in nature, affecting the heart, liver, and lung meridians, with functions including clearing heat, resolving phlegm, and facilitating orifices. It is indicated for conditions such as stroke with phlegm confusion, lung heat with phlegm congestion, convulsions, epilepsy, excessive phlegm in febrile diseases, high fever with thirst, irritability during pregnancy, and tetanus, with more clearly defined applications. Based on the results of the research, it is recommended that when developing and utilizing famous classical formulas containing Bambusae Succus, the one-year-old Phyllostachys nigra var. Henonis, which has been highly praised throughout history, should be selected as the source material. Industrial production should adopt the dry distillation method. Furthermore, in-depth research should be conducted on the modern technological characterization of the traditional quality control indicator of sweet taste, and reasonable modern quality control standards should be established.
6.Analysis of the current situation and influencing factors of platelet supply in medical institutions
Xuan WU ; Ting ZHANG ; Xiaozhen GUAN ; Yang YU
Chinese Journal of Blood Transfusion 2026;39(3):339-345
Objective: To systematically analyze the current status and influencing factors of platelet supply in medical institutions across China, and to explore the problems and future development directions of the existing supply models. Methods: From February 25 to March 5, 2025, a web-based questionnaire survey was performed. A self-designed questionnaire was distributed to staff in the blood transfusion departments of medical institutions nationwide in China. Data on the current status and influencing factors of platelet supply were collected and analyzed. Results: A total of 2 268 responses were collected in this survey, with 1 366 valid questionnaires finally included, covering 33 provinces, autonomous regions, and municipalities directly under the central government across China. The survey revealed that platelet supply in Chinese medical institutions exhibited a pattern of "sufficient in the eastern region, stable in the central region, and scarce in the western region": adequate in East China; generally favorable in South China except Guangxi; centered on Beijing and Tianjin in North China; basically met but with insufficient reserves in Central China; subject to seasonal fluctuations in Northeast China; only meeting the baseline supply in Yunnan, Guizhou, and Sichuan in Southwest China; and notably short in Qinghai, Ningxia, and Xinjiang in Northwest China. Family donor mobilization was required in 81.2% (1 109/1 366) of institutions, whereas this proportion was only 12.7% (173/1 366) among institutions with sufficient supply. Tertiary hospitals constituted the main users, among which tertiary Class A hospitals had the highest sufficiency rate, and secondary Class B hospitals showed the most pronounced shortage. A total of 84% (1 147/1 366) of institutions lacked a professional management team; only 19% (266/1 366) had an inventory warning system, of which 88% (234/266) considered it effective. Platelet reservation required 3 days in 33% (458/1 366) of institutions. The mandatory transfusion rate was 30.55% (29/118) when the reservation lead time exceeded 3 days, representing an increase of 5.98% compared with 24.57% (55/180) in the same-day reservation group. For optimization, most institutions called for improved blood donation services, strengthened education and incentives, establishment of regional coordination and policy collaboration, and supplementary suggestions focused on technologies for extending platelet shelf life. Conclusion: Regional imbalance in platelet supply across China is prominent, with supply shortages in some provinces, reliance on family donor mobilization in most institutions, weak grassroots support capacity, imperfect management systems, and supply timeliness constraining clinical practice. Systematic improvements are needed in optimizing blood donation services, strengthening regional coordination, improving relevant policies, and developing platelet preservation technologies, so as to enhance the level of supply security and patient safety.
7.Huangqi Jianzhongtang Regulates Polarization of Macrophages M1/M2 and Improves Fat Consumption in Cancer Cachexia Mice
Zhiyan FANG ; Haiyan ZHU ; Wenying HUAI ; Cong HUANG ; Ruocong YANG ; Haiyan YU ; Tiane ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):61-69
ObjectiveTo investigate the effects of Huangqi Jianzhongtang (HQJZ) on macrophage polarization and fat consumption in cancer cachexia (CC) mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry (UPLC-Q-Orbitrap HRMS) was used to control the quality of HQJZ. (1) In vitro experiment: HQJZ-containing serum was prepared, and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages (RAW264.7) were cultured and randomly divided into six groups, including a blank group, a classically activated macrophages (M1) group, an alternatively activated macrophages (M2) group, a HQJZ + blank group, a HQJZ+M1 group, and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86, inducible nitric oxide synthase (iNOS), CD206, and arginase-1 (Arg1) was detected by real-time quantitative polymerase chain reaction (Real-time PCR ). (2) In vivo experiment: Thirty-two BALB/c mice were randomly divided into a control group, a model group, a medroxyprogesterone acetate (MPA) group, and a HQJZ group. Except for the control group, the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA (0.13 g·kg-1·d-1) or HQJZ (13.13 g·kg-1·d-1) by gavage, respectively, while mice in the control and model groups were given an equal volume of saline by gavage, with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers (iNOS, Arg1, CD86, CD206) and fat browning-related genes uncoupling protein 1 (UCP1) and peroxisome proliferator-activated receptor γ (PPARγ) in epididymal adipose tissue. Western blot (WB) was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography (micro-CT) was used to measure residual fat volume, and hematoxylin-eosin (HE) staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro, the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that, compared with the blank group, Arg1 expression decreased in the HQJZ+blank group (P<0.05), CD206 showed a downward trend without statistical significance, while iNOS and CD86 expression were significantly increased (P<0.05). Compared with the M1 group, Arg1 and CD206 expression decreased in the HQJZ+M1 group (P<0.05). Compared with the M2 group, CD206 expression decreased in the HQJZ+M2 group (P<0.05), CD86 expression increased significantly (P<0.01). In vivo, Real-time PCR results showed that, compared with the control group, CD86 and CD206 expression levels were significantly increased in the model group (P<0.01). Compared with the model group, CD206 expression in the MPA group was significantly decreased (P<0.01). In the HQJZ group, CD206 was significantly decreased (P<0.01). WB results showed that, compared with the model group, protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group (P<0.05, P<0.01). micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group (P<0.05). HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group (P<0.05). ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization, thereby delaying fat consumption in CC mice.
8.Early predictive value of pre-treatment tear inflammatory factor levels in patients with dry eye
Yingxing JIANG ; Yuqiu XU ; Yunyun YANG ; Yu ZHANG
International Eye Science 2026;26(1):157-162
AIM: To investigate the application value of pre-treatment tear inflammatory factor levels in predicting therapeutic efficacy for dry eye patients.METHODS:Prospective controlled observational study. A total of 120 patients with dry eye(240 eyes)admitted to our hospital from November 2022 to March 2024 were included. Before dry eye treatment, the levels of inflammatory factors, including interlukin-4(IL-4), IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IL-18, IL-1β, interferon-γ(IFN-γ), tumor necrosis factor-α(TNF-α), granulocyte-colony stimulating factor(G-CSF), granulocyte-macrophage colony-stimulating factor(GM-CSF), monocyte chemoattractant protein-1(MCP-1)in the tear fluid were detected by ELISA. According to the treatment protocol in the Chinese Expert Consensus on the Treatment of Dry Eye(2020), the patients were given treatments, and the related factors affecting the treatment outcomes of dry eye patients were analyzed.RESULTS:After continuous treatment for 4 wk, all the patients completed follow-up, and they were divided into the markedly effective group(60 patients, 120 eyes)and the ineffective group(60 patients, 120 eyes)based on their therapeutic effects. The markedly effective group had significantly lower pre-treatment levels of IL-6, IL-10, IL-18, IL-1β, and TNF-α than the poor efficacy group(all P<0.05). IL-6(OR=0.994), IL-18(OR=0.998), IL-1β(OR=0.933), and TNF-α(OR=0.998)were independently associated with treatment efficacy(all P<0.05). The nomogram model yielded a C-index of 0.971(95% CI: 0.950-0.993), with calibration curves closely aligned to the ideal curve. The model demonstrated significant predictive value for early therapeutic efficacy(sensitivity=96.67%, specificity=71.67%, cutoff=208, AUC=0.866, 95% CI=0.794-0.952, P<0.001).CONCLUSION:The nomogram model constructed based on the levels of inflammatory factors in dry eye patients before treatment can well predict the treatment effect of patients.
9.In Vitro and In Vivo Chemical Composition Analysis of Reference Sample of Jinshui Liujunjian Based on UPLC-Q-TOF-MS/MS
Xinyue YANG ; Huiyu LI ; Yaqi LOU ; Xingxing WANG ; Guifang YU ; Chenfeng ZHANG ; Zhenzhong WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):166-173
ObjectiveTo elucidate the chemical composition of the reference sample of Jinshui Liujunjian and its distribution characteristics in blood and tissues of rats. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS/MS) was used to detect the reference sample solution, plasma, and tissue samples of Jinshui Liujunjian under positive and negative ion modes, respectively. Qualitative Analysis 10.0 software and a self-constructed database were employed for primary mass spectrum matching.Compound identification was further validated by comparing retention times, secondary mass spectral fragments, reference standards, and literature data to deduce fragmentation pathways. ResultsA total of 122 compounds were identified in the reference sample of Jinshui Liujunjian, including 47 flavonoids, 5 amino acids, 13 iridoids, 16 triterpenoid saponins, etc., of which 42 compounds were confirmed by comparison with reference substances. A total of 21 prototype components were identified in blood components; 50 prototype components were identified in different tissues, among which 13, 10, 7, 21, 11, 6, 14, and 40 prototype components were identified in the heart, liver, spleen, lung, kidney, brain, large intestine, and stomach, respectively. Among them, 7 compounds such as ferulic acid, glycyrrhizic acid, and nobiletin were exposed in the target organs of lung and kidney. ConclusionThis study elucidates the material basis of the reference samples of Jinshui Liujunjian, primarily composed of flavonoids and triterpenoid saponins, along with their in vivo distribution characteristics. These findings provide a scientific basis for establishing quality evaluation indicators and offer references for subsequent pharmacodynamic and pharmacokinetic investigations.
10.In Vitro and In Vivo Chemical Composition Analysis of Reference Sample of Jinshui Liujunjian Based on UPLC-Q-TOF-MS/MS
Xinyue YANG ; Huiyu LI ; Yaqi LOU ; Xingxing WANG ; Guifang YU ; Chenfeng ZHANG ; Zhenzhong WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):166-173
ObjectiveTo elucidate the chemical composition of the reference sample of Jinshui Liujunjian and its distribution characteristics in blood and tissues of rats. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS/MS) was used to detect the reference sample solution, plasma, and tissue samples of Jinshui Liujunjian under positive and negative ion modes, respectively. Qualitative Analysis 10.0 software and a self-constructed database were employed for primary mass spectrum matching.Compound identification was further validated by comparing retention times, secondary mass spectral fragments, reference standards, and literature data to deduce fragmentation pathways. ResultsA total of 122 compounds were identified in the reference sample of Jinshui Liujunjian, including 47 flavonoids, 5 amino acids, 13 iridoids, 16 triterpenoid saponins, etc., of which 42 compounds were confirmed by comparison with reference substances. A total of 21 prototype components were identified in blood components; 50 prototype components were identified in different tissues, among which 13, 10, 7, 21, 11, 6, 14, and 40 prototype components were identified in the heart, liver, spleen, lung, kidney, brain, large intestine, and stomach, respectively. Among them, 7 compounds such as ferulic acid, glycyrrhizic acid, and nobiletin were exposed in the target organs of lung and kidney. ConclusionThis study elucidates the material basis of the reference samples of Jinshui Liujunjian, primarily composed of flavonoids and triterpenoid saponins, along with their in vivo distribution characteristics. These findings provide a scientific basis for establishing quality evaluation indicators and offer references for subsequent pharmacodynamic and pharmacokinetic investigations.

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