1.The role of establishing the concept of"liver and pancreas co-management"in the treatment of pancreatic diseases
Kongyuan WEI ; Canitano NICOLA ; Shuo WANG ; Zipeng LU ; Kuirong JIANG ; Zhenhua MA ; Zheng WU ; Qingyong MA ; Marchegiani GIOVANNI ; Hackert THILO ; Zheng WANG
Chinese Journal of Surgery 2026;64(1):79-82
With the continuous development of new surgical technology, new equipment and new concepts, the research focused in the field of surgery is also in constant change. Among them, there are still confusion and controversies in the current clinical practice when facing the one-stop proposition of benefit population screening, advantageous surgical indication decision-making, surgical intervention timing selection, postoperative complication prediction and management. Therefore, our team tries to analyze whether the concept of"co-management of liver and pancreas"exists in clinical practice from the aspects of anatomy, physiology, histology and embryology of liver and pancreas, as well as the interaction between liver and pancreas, and explore the relationship between liver and pancreas in anatomy and tissue embryonic development, and the relationship between the concept of"co-management of liver and pancreas"and pancreatitis and pancreatic tumors as well as the concept of “co-management of liver and pancreas” applied in neoadjuvant chemoradiotherapy, and attempts to establish a new treatment pathway for pancreatic diseases based on this concept, in order to provide a new idea, new scheme and new possibility for the clinical research of pancreatic diseases and pancreatic surgery.
2.Exploring the Collateral Damage Mechanism and Sequential Treatment Strategy of Children IgA Vasculitis from the Perspective of "Wind Agitating Blood Turbidity"
Zhenhua YUAN ; Shuang XU ; Yingying JIANG ; Rongxin ZHU ; Yatong ZHANG ; Mingyang CAI ; Jingjing WU ; Hang SU ; Xianqing REN
Journal of Traditional Chinese Medicine 2026;67(18):1953-1956
As one of the common systemic vasculitides in children, IgA vasculitis is closely associated with the interaction of "Wind pathogen" and "turbid stasis" in its pathogenesis. Based on the blood turbidity theory, this paper proposes "wind agitating blood turbidity and collateral damage" as the core pathogenesis. Regarding treatment, the sequential therapeutic principle of "stanch bleeding, activating blood circulation, and nourishing blood" is adopted, and combined with the dynamic application of wind-dispelling medicinals to "expel, search, and guard against wind", turbidity-removing method is applied throughout all stages. In the acute stage,it is recommended to clear heat and purify turbidity, stanch bleeding and secure the collaterals. In the prolonged stage, the method of dissipating stasis and clearing up turbidity should be used, as well as activating blood circulation and unblocking the collaterals. In the recovery stage, it is advised to nourish blood to flourish the collaterals, reinforce healthy qi and resolve turbidity. This therapeutic system integrates the elimination of pathogens and the reinforcement of healthy qi to clear and resolve blood turbidity, ultimately achieving holistic collateral repair through securing, unblocking, and nourishing the collaterals, which provides new insights into the treatment of this disease in traditional Chinese medicine.
3.Chicken-Derived Medicinals for Pediatric Enuresis:An Analysis Based on Ancient Classical Literature
Min TONG ; Xianqing REN ; Zhenhua YUAN ; Yingying JIANG ; Yatong ZHANG ; Diya MA ; Zichao DING ; Rongxin ZHU ; Mingyang CAI ; Shuzi ZHANG ; Jialei CAO
Journal of Traditional Chinese Medicine 2026;67(18):1966-1972
ObjectiveTo systematically investigate the medication rules of chicken-derived medicinals for treating children enuresis in ancient Chinese medical classicals. MethodsThe China Medical Classics V5.0 database was searched to identify formulas and passages containing chicken-derived medicinals for pediatric enuresis. A database was established using Microsoft Excel 2021 to extract information including formulas, therapeutic categories, natures, flavors, channel entry, processing methods, dosage forms, and administration methods. Frequency analysis was performed, while association rule analysis and cluster analysis were conducted using R software. Gephi 0.10.1 software was used for complex network analysis. ResultsA total of 171 records were included, comprising 36 single-herb formulas and 135 compound formulas, sourced from 64 classical medical monographs. The identified chicken-derived medicinals included jichang (Intestinum Galli), jineijin (Endothelium Corneum Gigeriae Galli), jigan (Gallina Hepar), jishibai (Faeces Galli Albi), jisu (Ingluvies Galli), jiheling (Pluma Alae Galli), and jiweimao (Chicken tail feathers). The top three frequently used single herbs were jichang (17 times), jineijin (8 times), and jiheling (5 times). Among compound prescriptions, the three most frequently recorded formulas were Jineijin Powder (鸡内金散, 43 times), Jichang Powder (鸡肠散, 25 times), and Guigan Pills (桂肝丸, 24 times), with jineijin, jichang, and jigan being the predominant chicken-derived medicinals. When converting the daily dosage of chicken-derived medicines into modern dosage units, the dose ranged from 0.53 g to 33.57 g for jineijin, with 4.48 g being the most frequently used dose, and from 0.25 g to 30.00 g for jichang, with 17.90 g being the most frequently used dose. Chicken-derived medicinals were mostly used after processing, commonly employing burning (68 times), roasting/ stir-baking (37 times), and calcining (24 times) to preserve properties. Powders (117 times), pills (45 times), and decoctions (9 times) were the principal dosage forms, and administration with wine (70 times) was the most common method. The most frequently used herbal pair was jineijin and roucongrong (Herba Cistanches), while the core prescription combinations were Tusizi Powder (菟丝子散), Yangshi Jichang Powder (杨氏鸡肠散), and Rongxiang Pill (茸香丸). ConclusionChicken-derived medicinals , such as jichang and jineijin, are commonly processed by burning or roasting before use in the treatment of enuresis. They are often combined with longgu (Fossilia Ossis Mastodi), muli (Concha Ostreae), sangpiaoxiao (Oötheca Mantidis), roucongrong and rougui (Cortex Cinnamomi) to warm and tonify the kidney qi, arrest enuresis and emission with astringents. Pills and powders are the predominant dosage forms and are commonly administered before meals with wine or salted water.
4.Exploring the Pathogenic Characteristics and Treatment of Childhood Refractory Nephrotic Syndrome Based on "Directing the Turbid Downward with Wind Medicinals"
Lei HUA ; Qiongqiong XING ; Zhenhua YUAN ; Yingying JIANG ; Yuying SUN ; Jingjing WU ; Xianqing REN
Journal of Traditional Chinese Medicine 2026;67(19):2082-2085
Based on the view that wind pathogen runs through the entire course of the occurrence and development of nephrotic syndrome, it is proposed that the core pathogenesis of refractory nephrotic syndrome (RNS) in children involves imbalance of the lung, spleen, and kidney, invasion of wind pathogen, and stagnation of turbidity and stasis, and that directing the turbid downward with wind medicinals is the key therapeutic strategy. In clinical practice, according to the distinct pathogenic characteristics of three patterns, including defensive qi insecurity of the lung, yang deficiency with loss of regulation, and binding of turbidity and stasis, three corresponding methods are applied, which are diffusing the lung to consolidate defensive qi, elevating yang to supplement the spleen and kidney, and activating blood to unblock turbidity and stasis. For the pattern of defensive qi insecurity of the lung, wind medicinals are used to penetrate and disperse external pathogens, such as fangfeng (Radix Saposhnikoviae) and mahuang (Herba Ephedrae) for diffusing the lung, dispersing wind, and consolidating defensive qi. For yang deficiency with loss of regulation pattern, wind medicinals are employed to elevate yang and assist transformation, such as shengma (Rhizoma Cimicifugae) and gegen (Radix Puerariae Lobatae) for raising clear yang, warming and activating the spleen and kidney. For binding of turbidity and stasis pattern, wind medicinals with scurrying and collateral‑unblocking properties are used, such as jixueteng (Caulis Spatholobi), luoshiteng (Caulis Trachelospermi), and chuanshanlong (Rhizoma Dioscoreae Nipponicae) for dispelling wind, activating blood, resolving stasis, and directing turbidity downward. In all these methods, the core principle is to use wind medicinals to regulate qi movement, open and unblock the sweat pores, and separately eliminate turbid pathogens, thereby providing a theoretical and practical basis for the traditional Chinese medicine diagnosis and treatment of RNS in children.
5.Exploring the Pathogenic Characteristics and Treatment of Childhood Refractory Nephrotic Syndrome Based on "Directing the Turbid Downward with Wind Medicinals"
Lei HUA ; Qiongqiong XING ; Zhenhua YUAN ; Yingying JIANG ; Yuying SUN ; Jingjing WU ; Xianqing REN
Journal of Traditional Chinese Medicine 2026;67(19):2082-2085
Based on the view that wind pathogen runs through the entire course of the occurrence and development of nephrotic syndrome, it is proposed that the core pathogenesis of refractory nephrotic syndrome (RNS) in children involves imbalance of the lung, spleen, and kidney, invasion of wind pathogen, and stagnation of turbidity and stasis, and that directing the turbid downward with wind medicinals is the key therapeutic strategy. In clinical practice, according to the distinct pathogenic characteristics of three patterns, including defensive qi insecurity of the lung, yang deficiency with loss of regulation, and binding of turbidity and stasis, three corresponding methods are applied, which are diffusing the lung to consolidate defensive qi, elevating yang to supplement the spleen and kidney, and activating blood to unblock turbidity and stasis. For the pattern of defensive qi insecurity of the lung, wind medicinals are used to penetrate and disperse external pathogens, such as fangfeng (Radix Saposhnikoviae) and mahuang (Herba Ephedrae) for diffusing the lung, dispersing wind, and consolidating defensive qi. For yang deficiency with loss of regulation pattern, wind medicinals are employed to elevate yang and assist transformation, such as shengma (Rhizoma Cimicifugae) and gegen (Radix Puerariae Lobatae) for raising clear yang, warming and activating the spleen and kidney. For binding of turbidity and stasis pattern, wind medicinals with scurrying and collateral‑unblocking properties are used, such as jixueteng (Caulis Spatholobi), luoshiteng (Caulis Trachelospermi), and chuanshanlong (Rhizoma Dioscoreae Nipponicae) for dispelling wind, activating blood, resolving stasis, and directing turbidity downward. In all these methods, the core principle is to use wind medicinals to regulate qi movement, open and unblock the sweat pores, and separately eliminate turbid pathogens, thereby providing a theoretical and practical basis for the traditional Chinese medicine diagnosis and treatment of RNS in children.
6.The role of establishing the concept of"liver and pancreas co-management"in the treatment of pancreatic diseases
Kongyuan WEI ; Canitano NICOLA ; Shuo WANG ; Zipeng LU ; Kuirong JIANG ; Zhenhua MA ; Zheng WU ; Qingyong MA ; Marchegiani GIOVANNI ; Hackert THILO ; Zheng WANG
Chinese Journal of Surgery 2026;64(1):79-82
With the continuous development of new surgical technology, new equipment and new concepts, the research focused in the field of surgery is also in constant change. Among them, there are still confusion and controversies in the current clinical practice when facing the one-stop proposition of benefit population screening, advantageous surgical indication decision-making, surgical intervention timing selection, postoperative complication prediction and management. Therefore, our team tries to analyze whether the concept of"co-management of liver and pancreas"exists in clinical practice from the aspects of anatomy, physiology, histology and embryology of liver and pancreas, as well as the interaction between liver and pancreas, and explore the relationship between liver and pancreas in anatomy and tissue embryonic development, and the relationship between the concept of"co-management of liver and pancreas"and pancreatitis and pancreatic tumors as well as the concept of “co-management of liver and pancreas” applied in neoadjuvant chemoradiotherapy, and attempts to establish a new treatment pathway for pancreatic diseases based on this concept, in order to provide a new idea, new scheme and new possibility for the clinical research of pancreatic diseases and pancreatic surgery.
7.Differentiation and Treatment Strategies for Pediatric IgA Vasculitis Based on the Correlation Between Blood Turbidity Theory and Oxidative Stress
Zhenhua YUAN ; Yingying JIANG ; Mingyang CAI ; Rongxin ZHU ; Xianqing REN
Journal of Traditional Chinese Medicine 2026;67(5):567-570
This paper explores the differentiation and treatment strategies for pediatric IgA vasculitis based on the correlation between blood trubidity theory and oxidative stress. It is proposed that pediatric IgA vasculitis follows an evolution of pathogenesis characterized by "deficiency of healthy qi leading to turbidity generation, accumulation of turbid toxin, and toxin damage to the collateral vessels", which corresponds to the pathological process of oxidative stress, namely decreased antioxidant capacity with accumulation of reactive oxygen species, metabolite deposition, and endothelial cell injury. A staged treatment strategy is proposed. In the acute stage, wind-toxin invading the colla-terals and reckless movement of heat in the blood are the main manifestations, for which the treatment should focus on dispelling wind and venting pathogens, resolving toxins and unblocking the collaterals, with a modified Yinqiao Powder (银翘散) and Xijiao Dihuang Decoction (犀角地黄汤) to regulate oxidative stress burst. In the prolonged stage, intermingling of turbidity and stasis with collateral obstruction is emphasized; treatment should focus on resolving turbidity and dispelling stasis, harmonizing the blood and stabilizing the collaterals, and a modified Simiao Powder (四妙散) and Taohong Siwu Decoction (桃红四物汤) can be used to improve microcirculatory dysfunction. In the remission stage, when healthy qi remains insufficient and residual pathogens persist, treatment should focus on strengthening the root and clearing the source, reinforcing healthy qi and nourishing the collaterals, for which modified Zhibai Dihuang Pill (知柏地黄丸) and Yupingfeng Powder (玉屏风散) is suggested to rebuild the antioxidant defense system.
8.Treatment of Refractory Nephrotic Syndrome in Children from the Perspective of "Cold Qi Generates Turbidity"
Zhenhua YUAN ; Pan WANG ; Jingjing WU ; Mingyang CAI ; Shuang XU ; Yingying JIANG ; Yatong ZHANG ; Xiaoyu LIU ; Yuhang NIU ; Xilin CHEN ; Xianqing REN
Journal of Traditional Chinese Medicine 2026;67(20):2236-2239
Based on the theory of "cold qi generates turbidity" described in the Inner Canon of Yellow Emperor (《黄帝内经》), together with the physiological characteristics of children, who are considered to have an inherent insufficiency of the lung, spleen, and kidney, and the clinical features of recurrent refractory nephrotic syndrome (RNS), this article proposes that the pathogenesis of RNS in children is characterized by yang deficiency with internal cold, turbidity arising from cold, latent turbidity transforming into toxin, activation by newly contracted pathogens, and turbid toxins damaging the collaterals. The core pathogenesis is identified as yang deficiency, turbidity coagulation, and collateral damage. Accordingly, the general treatment principle is warming yang and eliminating turbidity, with coordination of three methods including warming yang to strengthen the body's foundation, promoting yang to relieve constraint, and raising yang while replenishing qi. Zhenwu Decoction (真武汤) is employed as the basic prescription with modification according to syndrome differentiation, to achieve an effect eliminating turbidity and arresting leakage, restoring kidney function by unblocking the collaterals, and consolidating recovery to prevent relapse.
9.Research progress of individualized choice of treatment for early-stage primary hepatocellular carcinoma patients
Xuewei JIANG ; Awang DANZENG ; Xiaoyin YUAN ; Ling GUO ; Zhengwei HE ; Zhenhua YANG ; Hang WU ; Binhao ZHANG
Chinese Journal of Hepatobiliary Surgery 2025;31(3):231-236
Hepatocellular carcinoma (HCC) is a prevalent malignant tumor that poses a significant threat to public health. Advances in medical science and increased screening awareness have improved early-stage diagnosis rates, allowing more patients to undergo radical treatment at initial diagnosis. Concurrently, ongoing developments in treatment modalities have expanded the options available for both patients and clinicians. The challenge now lies in making informed decisions to achieve individualized precision medicine, which merits thorough exploration. This article aims to review the latest research on personalized treatment strategies for early-stage HCC, providing a reasonable reference and valuable insights for clinicians.
10.Advances in thermal ablation therapy for colorectal cancer liver metastases
Ling GUO ; Awang DANZENG ; Xuewei JIANG ; Xiaoyin YUAN ; Zhengwei HE ; Zhenhua YANG ; Hang WU ; Binhao ZHANG
Chinese Journal of Hepatobiliary Surgery 2025;31(5):384-388
The liver is the most common anatomical site for hematogenous metastases of colorectal cancer. Hepatic resection is the preferred treatment for colorectal cancer liver metastasis (CRLM). However, a disappointingly small proportion of patients are deemed suitable for surgical resection upon initial consultation. Failure to adequately address these metastatic tumors results in a dire 5-year survival rate of less than 5%. In recent times, thermal ablation, a minimally invasive procedure aimed at controlling local tumor progression, has undergone rigorous validation and garnered recognition for its effectiveness and safety in managing CRLM. This article endeavors to review the advancements in research concerning thermal ablation in the treatment of CRLM, exploring its efficacy, safety profile, and the promising avenues for its clinical application.

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