1.Development and evaluation of classification system for drug-related problems in China
Shuang ZOU ; Tingting LU ; Lei BAO ; Yun LIAO ; Ling LI ; Ping ZHANG
China Pharmacy 2026;37(3):371-376
OBJECTIVE To establish a Chinese drug-related problem (DRP) classification system applicable to pharmacist-led pharmaceutical care in China, providing pharmacists with an effective and practical tool for pharmaceutical care. METHODS A multi-stage process was employed to construct the DRP classification system, including literature review and analysis, comparison of existing classification systems, refinement of classification items and framework development, two rounds of standard case validation, expert discussion, and system revision. The Fleiss′ kappa test was used to calculate the consistency coefficient κ, assessing the reliability of pharmacists participating in evaluating the classification system. An electronic questionnaire comprising six items was employed to evaluate the system’s applicability. RESULTS The constructed Chinese DRP classification system comprised six sections [problem(including potential problems), DRP evaluation, cause (including possible causes of potential problems), intervention, acceptance of intervention and DRP status], with 24 primary codes and 96 secondary codes. In the first round of case validation, κ values exceeded 0.4 for all sections except “intervention” and “DRP status”. In the second round, κ values exceeded 0.4 for all sections. In the applicability evaluation of the classification system, positive ratings (“strongly agree” or “agree”) exceeded 85% for all items. Specifically, positive ratings for“the classification system can provide appropriate category selection”,“ the classification system is comprehensive”,“ the classification system is convenient to use” and “the classification system is highly satisfactory” exceeded 92%. CONCLUSIONS The Chinese DRP classification system developed demonstrates both high reliability and applicability, providing an effective and practical classification tool for pharmacists in China to conduct pharmaceutical care.
2.Early warning of influenza epidemic based on CUSUM and EWMA models in Daxing District, Beijing
Hong LEI ; Qiuling LI ; Qi LIU ; Meichen LIU ; Enhuan DU ; Jinfeng TANG ; Zhiping LI ; Yadi GAN ; Lijie ZHANG
Journal of Public Health and Preventive Medicine 2026;37(1):13-17
Objective To explore the effectiveness of the cumulative sum (CUSUM) and the exponentially weighted moving average (EWMA) for early warning of influenza epidemic using two datasets of reported influenza cases and influenza-like illness (ILI) cases. Methods Using the reported cases of influenza and ILI in Daxing District, Beijing, from week 23 of 2018 to week 22 of 2024 as data sets, the CUSUM and EWMA models were established, respectively. The positive rate of influenza etiology was used as the “gold standard”, and the Youden index was used as the evaluation index to compare the early warning effect of the two models under different data sets and different parameters. Results In CUSUM, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.751 and 0.635, respectively. In EWMA, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.544 and 0.464, respectively. The optimal EWMA and CUSUM models could both issue early warning signals in advance of the “gold standard”. Conclusion In the influenza epidemic early warning in Daxing District, Beijing, the CUSUM model established with the reported cases of influenza can achieve good early warning effects, but the model parameters need to be dynamically adjusted according to the local epidemic characteristics.
3.Mechanism of NAFLD-associated Intestinal Barrier Damage and Traditional Chinese Medicine Intervention Strategies Based on "Turbid Pathogenic Factors Entering the Blood" Theory
Haoyang QIN ; Lei LUO ; Mengge LI ; Xueqian KONG ; Fanghua ZHANG ; Zhongqin DANG ; Zhibo DANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):277-287
Intestinal barrier damage is a prominent feature of non-alcoholic fatty liver disease (NAFLD) and serves as a critical factor driving the progression from simple fatty liver to non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. The "turbid pathogenic factors entering the blood" theory integrates classical traditional Chinese medicine (TCM) principles with contemporary disease evolution trends and research findings. It posits that endogenous turbid pathogenic factors within the body infiltrate the blood vessels, leading to impure and viscous blood quality, thereby triggering various diseases. Based on this theory, this article elucidated the pathogenic mechanism of NAFLD-associated intestinal barrier damage. It argued that in NAFLD, the liver loses its dredging function, and the spleen becomes obstructed and dysfunctional. Moreover, essential nutrients fail to be properly transformed, resulting in the internal generation of turbid pathogenic factors. This subsequently initiates a series of pathological changes, namely, "infiltration of phlegm-turbidity into the blood, eroding the intestinal mucosa", "infiltration of glucose-turbidity into the blood, macerating and eroding the intestinal mucosa", "infiltration of heat-turbidity into the blood, scorching and eroding the intestinal mucosa", and "infiltration of stasis-turbidity into the blood, stagnating and eroding the intestinal mucosa", ultimately causing intestinal barrier damage. Furthermore, guided by the "turbid pathogenic factors entering the blood" theory, this article explored TCM intervention strategies: employing medicinals targeting the liver meridian to address the root cause and reduce the generation and deposition of turbid pathogenic factors in the liver, administering blood-system medicinals to clear the blood and purge turbidity, thereby intercepting the progression of the disease mechanism, and applying tonifying medicinals to bolster healthy Qi and defend against turbid invasion, allowing the damaged intestinal mucosa to gradually heal. This article presented novel theoretical and medicinal perspectives for analyzing NAFLD-associated intestinal barrier damage based on the "turbid pathogenic factors entering the blood" theory, aiming to provide new entry points and broader horizons for related research and clinical practice.
4.Microscopic Mechanism of Ulcerative Colitis and New Ideas on Medicine Management Based on Theory of Mutual Interference Between Lucidity and Turbidity
Yuying XU ; Changpu ZHAO ; Lei LUO ; Renwu CHEN ; Zishun LI ; Meiling LI ; Rongzhi LI ; Yu ZHANG ; Guangjie SHU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):288-299
The chapter Zhouyu in Guoyu says "Qi of the heaven and the earth moves without losing its order." With lucidity ascending and turbidity descending, Qi moves in a normal state, and Yin and Yang consolidate the foundation of the body. The mutual interference between lucidity and turbidity leads to the disorder of Qi movement, thus causing diseases. It is a pathological state of disorder between ascending and descending, as well as between entering and exiting, gradually evolving into a state of turbidity affecting lucidity and transforming into pathogen, which can be used to interpret and analyze the core of disease pathogenesis. The theory of lucidity and turbidity is connected with the harmony of nutrient and defensive aspects, Qi circulation, and sweat pore associating with Qi movement, and it has common implications with immune responses and nutrient metabolism system, intestinal mucosal barrier function, and mitochondrial energy synthesis. Modern studies have shown that intestinal flora imbalance, bile acid receptor inactivation, macrophage polarization imbalance, epithelial-mesenchymal transition, ferroptosis and other related microscopic pathological mechanisms are involved in the development and progression of ulcerative colitis. By delving into the common meaning of the classic theory of mutual interference between lucidity and turbidity in traditional Chinese medicine and modern medical pathological mechanisms, this paper summarizes the correspondence between the micropathological mechanism and the theory of mutual interference between lucidity and turbidity in the regulation and mamagement of ulcerative colitis. The combined use of sweet and warm medicinal materials consolidates the middle Qi and activates Qi circulation, thus ascending lucidity and descending turbidity. The combined use of pungent medicinal materials for dispersing and bitter medicinal materials for descending simultaneously raises warm and clear Qi. Wind-extinguishing medicinal materials facilitate the ascending of Qi and the opening of sweat pores. Accordingly, turbidity descends and lucidity ascends. The prescriptions incorporating these medication principles are in agreement with the therapeutic approach of following the normal flow of lucidity and turbidity. This paper clarifies the scientific connotation and micropathologic mechanism of ulcerative colitis from the perspective of mutual interference between lucidity and turbidity, providing new theories and prescriptions for the clinical diagnosis, treatment, and prevention of ulcerative colitis.
5.Exploration on Scientific Connotation of "Removing Calyx" of Inulae Flos Based on Processing Experience of Old Medicine Workers
Qiao ZHOU ; Zhenni QU ; Menghan LIU ; Lei ZHANG ; Benzheng SU ; Yanpeng DAI ; Dianhua SHI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):260-266
ObjectiveTo conduct a comparative quality analysis of Inulae Flos, fuzz of Inulae Flos and calyx of Inulae Flos, elucidating the scientific connotation of the "removing calyx" process in the traditional processing of Inulae Flos. MethodsInulae Flos decoction pieces were collected, and the fuzz and calyx of Inulae Flos were prepared according to the experiences of old medicine workers. Subsequently, according to the methods under the "Inulae Flos" item in the 2025 edition of the Pharmacopoeia of the People's Republic of China, the appearance characteristics and thin-layer chromatography(TLC) identification of these samples were tested, and the moisture content, total ash content, extract content were also measured. The characteristic fingerprint patterns of Inulae Flos and fuzz of Inulae Flos were established by high-performance liquid chromatography(HPLC), followed by similarity evaluation, principal component analysis(PCA), and partial least squares-discriminant analysis(PLS-DA). The contents of cryptochlorogenic acid, caffeic acid, 1,3-O-dicaffeoylqunic acid, 1,5-O-dicaffeoylqunic acid, and 1-O-acetyl britannilactone were determined to compare the quality differences of Inulae Flos, fuzz of Inulae Flos, and calyx of Inulae Flos. ResultsThe moisture content of Inulae Flos, fuzz of Inulae Flos, and calyx of Inulae Flos was all<10%. The determination results of total ash content were as follows:Calyx of Inulae Flos>Inulae Flos>fuzz of Inulae Flos, and the determination results of alcohol-soluble extract content were as follows:Fuzz of Inulae Flos>Inulae Flos>calyx of Inulae Flos. HPLC fingerprint patterns of Inulae Flos and fuzz of Inulae Flos were established, and 22 common peaks were identified. The similarity analysis and PCA showed that the overall quality of Inulae Flos and fuzz of Inulae Flos was similar, while the overall quality of calyx of Inulae Flos differed significantly from that of Inulae Flos and fuzz of Inulae Flos. PLS-DA results showed that Inulae Flos, fuzz of Inulae Flos, and calyx of Inulae Flos clustered into distinct groups, indicating significant differences among them. Cryptochlorogenic acid and caffeic acid had relatively high contents in calyx of Inulae Flos, the contents of 1,3-O-dicaffeoylqunic acid and 1,5-O-dicaffeoylqunic acid in Inulae Flos and fuzz of Inulae Flos were higher than those in calyx of Inulae Flos. The order of 1-O-acetyl britannilactone content was determined as follows:fuzz of Inulae Flos>Inulae Flos>calyx of Inulae Flos. ConclusionThe scientific nature of "Removing Calyx" process in the cleansing of Inulae Flos by old medicine workers is demonstrated by the resulting fuzz of Inulae Flos decoction pieces exhibiting enhanced cleanliness and higher content of the index component 1-O-acetyl britannilactone. This study provides a reference basis for further improving and enhancing the processing method and quality control standards of Inulae Flos.
6.A retrospective analysis of clinical outcomes: a retroauricular transmeatal approach for condylar fractures
ZHANG Jiaxiang ; GAO Yu ; Sadam Ahmed Elayah ; LIU Lei ; CHEN Jinlong
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(3):246-254
Objective:
To evaluate the safety and efficacy of the retroauricular transmeatal approach in the treatment of condylar head and neck fractures, and to provide a reference for clinical practice.
Methods:
This study has been reviewed and approved by the institutional medical ethics committee and has obtained informed consent from the patients. A retrospective analysis was conducted on the clinical data of patients with condylar head and neck fractures treated via the retroauricular transmeatal approach between March and October 2024. Postoperative follow-up was performed for at least 3 months, including clinical and radiographical evaluations. The assessed parameters included facial nerve function, temporal region numbness, hematoma, infection, salivary fistula, mouth opening, malocclusion, mandibular movement function, temporomandibular joint (TMJ) pain and clicking, external auditory canal (EAC) stenosis, hearing function impairment, surgical scar concealment, postoperative reduction and fixation outcomes.
Results:
A total of 16 patients with condylar fractures were treated via the retroauricular transmeatal approach, including 10 unilateral and 6 bilateral cases. Specifically, 18 sides were condylar head fractures, and 4 sides were condylar neck fractures. All patients achieved a House-Brackmann Grade I, indicating normal facial nerve function postoperatively. On postoperative day 1, 3 sides experienced temporal numbness in the temporal region on the surgical side, with spontaneous resolution in all cases. All patients recovered after surgery without hematoma, infection, or salivary fistula. Limited mouth opening was improved (14 cases with restricted mouth opening preoperatively vs. 3 cases postoperatively). No malocclusion occurred in any patient. All patients achieved satisfactory recovery of postoperative mandibular movement function, manifested as restored range of motion without pain. No TMJ clicking was observed within 3 months after surgery. One keloid-prone patient developed progressive EAC stenosis (2 mm lumen constriction) accompanied by conductive hearing impairment, which recovered after dilation therapy. All patients were satisfied with the aesthetic outcomes. Radiographically parametric assessment demonstrated satisfactory fracture reduction and fixation; with no loosening of titanium plates or screws.
Conclusion
The retroauricular transmeatal approach effectively reduces the risk of facial nerve injury and salivary fistulas formation with providing concealed scarring and high patient satisfaction. However, caution should be exercised regarding EAC stenosis, especially for keloid-prone patients.
7.Treatment of Colorectal Cancer with Traditional Chinese Medicine Based on Hippo Signaling Pathway: A Review
Shuo ZENG ; Suqin HU ; Yang HU ; Lei LUO ; Mingyan LI ; Qinsheng ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):297-305
Colorectal cancer, a leading malignant gastrointestinal tumor globally in terms of incidence and mortality, has seen a consistent annual rise in newly diagnosed cases. While conventional therapies like radiotherapy, chemotherapy, and surgery are available, problems such as lack of early diagnosis, poor prognosis, and drug resistance remain significant burdens for patients. Given the complex and diverse pathogenesis of colorectal cancer, there is an urgent clinical need for safe, effective, reliable, and multi-targeted therapeutic strategies. The Hippo signaling pathway, closely linked to mechanisms like tumorigenesis, cancer cell invasion, migration, and drug resistance, extensively participates in the occurrence and development of colorectal cancer, so targeting the signaling pathway for cancer prevention and treatment has become a crucial research direction in recent years. Traditional Chinese medicine (TCM) offers multi-faceted, multi-pathway, and multi-target advantages and becomes an important therapy for colorectal cancer by enhancing patients' immunity, improving the life quality, and prolonging survival. Studies show that the active components of TCM, including flavonoids, terpenoids, phenols, alkaloids, quinones, lignans, and saponins, as well as TCM compounds such as modified Sijunzi decoction, Jiedu Sangen decoction, Jianpi Jiedu compound, and Quyu Jiedu decoction, exhibit significant targeting effects on the Hippo signaling pathway. These TCMs can exert an anti-colorectal cancer effect through various mechanisms, such as inducing cancer cell autophagy and apoptosis, inhibiting epithelial-mesenchymal transition, reversing drug resistance of the tumor, and blocking the cancer cell cycle. This paper reviewed and analyzed Chinese and international research on the action mechanisms of TCM in regulating the Hippo signaling pathway for the prevention and treatment of colorectal cancer with a comprehensive overview presentation, aiming to provide new references and ideas for the clinical application of TCM and the development of new pharmacological agents in the prevention and treatment of colorectal cancer.
8.Treatment of Colorectal Cancer with Traditional Chinese Medicine Based on Hippo Signaling Pathway: A Review
Shuo ZENG ; Suqin HU ; Yang HU ; Lei LUO ; Mingyan LI ; Qinsheng ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):297-305
Colorectal cancer, a leading malignant gastrointestinal tumor globally in terms of incidence and mortality, has seen a consistent annual rise in newly diagnosed cases. While conventional therapies like radiotherapy, chemotherapy, and surgery are available, problems such as lack of early diagnosis, poor prognosis, and drug resistance remain significant burdens for patients. Given the complex and diverse pathogenesis of colorectal cancer, there is an urgent clinical need for safe, effective, reliable, and multi-targeted therapeutic strategies. The Hippo signaling pathway, closely linked to mechanisms like tumorigenesis, cancer cell invasion, migration, and drug resistance, extensively participates in the occurrence and development of colorectal cancer, so targeting the signaling pathway for cancer prevention and treatment has become a crucial research direction in recent years. Traditional Chinese medicine (TCM) offers multi-faceted, multi-pathway, and multi-target advantages and becomes an important therapy for colorectal cancer by enhancing patients' immunity, improving the life quality, and prolonging survival. Studies show that the active components of TCM, including flavonoids, terpenoids, phenols, alkaloids, quinones, lignans, and saponins, as well as TCM compounds such as modified Sijunzi decoction, Jiedu Sangen decoction, Jianpi Jiedu compound, and Quyu Jiedu decoction, exhibit significant targeting effects on the Hippo signaling pathway. These TCMs can exert an anti-colorectal cancer effect through various mechanisms, such as inducing cancer cell autophagy and apoptosis, inhibiting epithelial-mesenchymal transition, reversing drug resistance of the tumor, and blocking the cancer cell cycle. This paper reviewed and analyzed Chinese and international research on the action mechanisms of TCM in regulating the Hippo signaling pathway for the prevention and treatment of colorectal cancer with a comprehensive overview presentation, aiming to provide new references and ideas for the clinical application of TCM and the development of new pharmacological agents in the prevention and treatment of colorectal cancer.
9.Chinese expert consensus on the diagnosis and treatment of chronic pain after lung surgery with integrated Traditional Chinese and Western medicine (2026 edition)
Jichen QU ; Wentian ZHANG ; Jianqiao CAI ; Zhigang CHEN ; Bin LI ; Wei DAI ; Xiangwu WANG ; Yan LI ; Xiang LÜ ; ; Yongfu ZHU ; Mingran XIE ; Sufang ZHANG ; Lei JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(04):522-534
Chronic post-surgical pain (CPSP) is a common long-term complication following lung surgery. Its high incidence significantly impacts patients’ quality of life and functional recovery, and imposes a substantial socioeconomic burden. This consensus aims to systematically establish a standardized integrated Chinese and Western medicine diagnostic and treatment framework for chronic post-lung surgery pain (CPLSP). Based on the latest domestic and international evidence-based medical research and multidisciplinary clinical experience, the working group comprehensively elaborates on core issues regarding CPLSP, including its definition, epidemiology, pathogenesis, clinical assessment, Western medical treatment, traditional Chinese medicine (TCM) treatment, and integrated strategies. The consensus emphasizes a patient-centered approach, adhering to the principles of multimodality, individualization, and stepwise management, highlighting the synergistic advantages of integrating Chinese and Western medicine throughout the entire perioperative management cycle encompassing "perioperative anti-inflammation, acute analgesia, and chronic rehabilitation." Through systematic literature retrieval and evidence integration, a total of 9 core recommendations were established to provide scientifically sound and clinically practical guidance.
10.Isotemporal substitution analysis of 24 hour activity behaviors on fine motor development among preschool children
ZHANG Chu an, WEN Lei, FU Jinmei, ZHANG Zhiyu, ZHANG Shuna, WEN Xinghui, ZHAO Guanggao
Chinese Journal of School Health 2026;47(3):413-416
Objective:
To investigate the relationship between 24 hour activity behaviors and fine motor development in preschool children, and to simulate the effects of reallocating time among different activity behaviors on fine motor development using isotemporal substitution analysis.
Methods:
From March to July 2022, a stratified cluster random sampling method was used to recruit 447 preschool children aged 3-6 years (254 boys and 193 girls) from Pingxiang City, Jiangxi Province. The 24 hour activity behaviors in preschool children were measured using ActiGraph wGT3-BT accelerometers and subjective sleep reports. Fine motor development was assessed using the Gesell Developmental Schedules. A component linear regression model was employed to analyze the impact of 24 hour activity behaviors on the development of fine motor activities, and the potential effects of adjusting activity behaviors were simulated through an isochoric substitution model.
Results:
The daily durations of sedentary behavior (SB) was ( 572.92 ±102.96) min (accounting for 39.79% of 24 h), the duration of light physical activity (LPA) was (131.21± 38.11 ) min ( 9.11% ), the duration of moderate to vigorous physical activity (MVPA) was (65.61±22.21) min (4.56%), and sleep duration was (670.65±57.58) min (46.82%). Sleep composition was positively associated with fine motor development ( β =2.74), while MVPA ( β =-0.84) and SB ( β =-1.93) compositions were negatively associated with fine motor development (all P <0.01). Isochoric substitution analysis showed that sleep had positive effects on the development of fine motor skills when replacing other activity behaviors (all P < 0.05), with the substitution effect for MVPA being the most significant and gradually increasing with the duration of substitution (60 min: β =28.66); sleep replacement of SB and LPA also showed positive effects (60 min: β =4.25, 2.00) (all P < 0.05). On the contrary, the substitution of sleep with MVPA showed negative effects (60 min: β =-7.86), and the substitution of LPA and SB with MVPA also showed negative effects (60 min: β =-5.65, -3.40) (all P <0.05).
Conclusions
The overall composition of 24 hour activity behaviors is associated with fine motor development in preschool children, with sleep playing a crucial role. Ensuring adequate sleep and optimizing the structure of activity behaviors may effectively promote the development of fine motor skills in preschool children.


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