1.Traditional Chinese medicine for recurrent pregnancy loss: A systematic review and network meta-analysis
Zilin LONG ; Houyu ZHAO ; Fengqi LIU ; Meng ZHANG ; Junchang LIU ; Siyan ZHAN ; Feng SUN
Science of Traditional Chinese Medicine 2026;4(1):87-95
Background: Recurrent pregnancy loss undermines the physical and mental health of women. Recent randomized controlled trials have reported some effects of traditional Chinese medicine (TCM); however, whether various TCM methods have different effectiveness remains unclear. Objective: To comprehensively evaluate the efficacy and adverse events of TCM for patients with RPL and to explore whether various TCM methods have different effectiveness. Methods: Ten databases were searched up to May 27, 2024. The risk of bias was assessed using the RoB2 tool. The certainty of the evidence was evaluated using the grading of Recommendations, Assessment, Development, and Evaluation tool. Pairwise and network analyses were conducted using Stata 18.0. Results: A total of 47 randomized controlled trials enrolling 6678 women with RPL were included. Pairwise analysis showed that use of TCM had a significantly lower miscarriage rate (RR 0.50 [95% CI 0.45, 0.55]), lower preterm birth rate (RR 0.81 [95% CI 0.67, 0.98), and lower adverse event rate (RR 0.46 [95% CI 0.37, 0.58]). Moreover, use of TCM was associated with a higher alive-fetus rate (RR 1.21 [95% CI 1.15, 1.26]), live-birth rate (RR 1.20 [95% CI 1.15, 1.25]), and full-term rate (RR 1.37 [95% CI 1.23, 1.53]) compared with nonuse of TCM. Network analysis demonstrated that Bushenshugan combined with conventional Western medicine was ranked the best for the reduction of miscarriage rate. Discussion: Use of TCM is more likely to improve pregnancy outcomes and reduce adverse events compared with nonuse of TCM in patients with RPL. Different TCM methods have differences in reducing the miscarriage rate. The Bushenshugan method might be a potential optimal TCM therapy, but more high-quality evidence is needed to further validate and evaluate the efficacy and safety.
2.Tracing Development of LIU Wansu's Theory of ''Fire-heat Inducing Stroke''
Xin LAN ; Changxiang LI ; Haojia ZHANG ; Jialin CHENG ; Zijin SUN ; Liyang DONG ; Zilin REN ; Xueqian WANG ; Fafeng CHENG ; Qingguo WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):32-41
LIU Wansu, as the foremost of the four great masters of the Jin-Yuan period, established the "theory of fire-heat'' and extended the fire-heat pathogenesis framework to the field of stroke, thereby forming the theory of ''fire-heat inducing stroke''. This achieved a paradigmatic shift in stroke etiology from ''exogenous wind inducing stroke'' to ''fire-heat inducing stroke''. This paper systematically reviews the developmental trajectory of LIU Wansu's ''fire-heat inducing stroke'' theory and explores the social background, academic origins, and core connotations of its theoretical construction. The study found that, based on the ''Nineteen Pathomechanisms'' in the Huangdi's Internal Classic (Huang Di Nei Jing) and combined with clinical practice, LIU Wansu proposed that fire-heat is the fundamental cause of stroke, and that the Six Climatic Factors and the Five Zhi-Emotions can all transform into fire. He further constructed a stratified syndrome differentiation and therapeutic system centered on clearing heat and purging fire, emphasizing differentiated treatment of exterior and interior syndromes, Six Meridians syndrome differentiation, and seasonally adjusted medication. This theory not only resolved the diagnostic and therapeutic dilemmas of febrile epidemic diseases during the Jin-Yuan period, but also exerted a profound influence on later physicians such as ZHANG Zihe and ZHU Danxi, thereby promoting the pluralistic development of stroke theory in traditional Chinese medicine (TCM). Modern pharmacological research provides solid scientific evidence, confirming that the ''fire-heat'' pathological state is highly associated with key mechanisms such as excessive inflammatory responses, oxidative stress, and excitatory amino acid toxicity following cerebral ischemia. Heat-clearing and fire-purging prescriptions and agents, such as Huanglian Jiedu Tang and baicalin, can exert multi-target neuroprotective effects by regulating inflammatory signaling, enhancing antioxidant enzyme activity, and balancing neurotransmitters. This not only verifies the scientific basis of the ''fire-heat inducing stroke'' theory from a modern biological perspective but also provides conclusive evidence for the clinical application of heat-clearing and fire-purging therapy. LIU Wansu's ''fire-heat inducing stroke'' theory represents a major milestone in the historical understanding of stroke pathogenesis, and its academically transitional insights continue to hold core guiding value for the pattern identification and treatment of ischemic stroke today.
3.Tracing Development of LIU Wansu's Theory of ''Fire-heat Inducing Stroke''
Xin LAN ; Changxiang LI ; Haojia ZHANG ; Jialin CHENG ; Zijin SUN ; Liyang DONG ; Zilin REN ; Xueqian WANG ; Fafeng CHENG ; Qingguo WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):32-41
LIU Wansu, as the foremost of the four great masters of the Jin-Yuan period, established the "theory of fire-heat'' and extended the fire-heat pathogenesis framework to the field of stroke, thereby forming the theory of ''fire-heat inducing stroke''. This achieved a paradigmatic shift in stroke etiology from ''exogenous wind inducing stroke'' to ''fire-heat inducing stroke''. This paper systematically reviews the developmental trajectory of LIU Wansu's ''fire-heat inducing stroke'' theory and explores the social background, academic origins, and core connotations of its theoretical construction. The study found that, based on the ''Nineteen Pathomechanisms'' in the Huangdi's Internal Classic (Huang Di Nei Jing) and combined with clinical practice, LIU Wansu proposed that fire-heat is the fundamental cause of stroke, and that the Six Climatic Factors and the Five Zhi-Emotions can all transform into fire. He further constructed a stratified syndrome differentiation and therapeutic system centered on clearing heat and purging fire, emphasizing differentiated treatment of exterior and interior syndromes, Six Meridians syndrome differentiation, and seasonally adjusted medication. This theory not only resolved the diagnostic and therapeutic dilemmas of febrile epidemic diseases during the Jin-Yuan period, but also exerted a profound influence on later physicians such as ZHANG Zihe and ZHU Danxi, thereby promoting the pluralistic development of stroke theory in traditional Chinese medicine (TCM). Modern pharmacological research provides solid scientific evidence, confirming that the ''fire-heat'' pathological state is highly associated with key mechanisms such as excessive inflammatory responses, oxidative stress, and excitatory amino acid toxicity following cerebral ischemia. Heat-clearing and fire-purging prescriptions and agents, such as Huanglian Jiedu Tang and baicalin, can exert multi-target neuroprotective effects by regulating inflammatory signaling, enhancing antioxidant enzyme activity, and balancing neurotransmitters. This not only verifies the scientific basis of the ''fire-heat inducing stroke'' theory from a modern biological perspective but also provides conclusive evidence for the clinical application of heat-clearing and fire-purging therapy. LIU Wansu's ''fire-heat inducing stroke'' theory represents a major milestone in the historical understanding of stroke pathogenesis, and its academically transitional insights continue to hold core guiding value for the pattern identification and treatment of ischemic stroke today.
4.WANG Qingguo's Experience in Treatment of Headache Based on the Concept of "Achieving Harmony by Unblocking and Balancing"
Chuxin ZHANG ; Zilin REN ; Yang ZHAO ; Jinhua HAN ; Bomin ZHANG ; Fafeng CHENG ; Changxiang LI ; Xueqian WANG ;
Journal of Traditional Chinese Medicine 2026;67(9):935-940
This paper summarizes professor WANG Qingguo's experience in treatment of headache based on the "achieving harmony by unblocking and balancing" concept. It is considered that although the pathogenesis of headache is generally attributed to "pain arises from obstruction" and "pain arises from malnourishment", clinical presentations often involve a complex mixture of deficiency and excess, as well as cold and heat patterns. Professor WANG proposes the diagnostic and therapeutic theory of "achieving harmony by unblocking and balancing", advocating for equal emphasis on "freeing the flow of qi and blood" and "regulating the balance of yin and yang". He has summarized eight treatment methods for common headache patterns. For wind-cold attacking the collaterals, treatment should focus on dispersing and unblocking through modified Gegen Decoction (葛根汤). For wind-dampness binding, it is recommended to unblock and drain, using modified Qingshang Juantong Decoction (清上蠲痛汤). For damp-heat congestion, unblocking and clearing is the method, using modified Toufeng Shen Formula (头风神方). For liver-gallbladder qi constraint, unblocking and soothing is the treatment principle, and modified Sanpian Decoction (散偏汤) is suggested. For insufficiency of center qi, even supplementation method is recommended, and modified Yiqi Congming Decoction (益气聪明汤) can be used. For liver yang hyperactivity, unblocking and subduing are combined, using modified Xunlong Decoction (驯龙汤). For deficiency-cold in the liver and stomach, warming, harmonizing, unblocking, and descending are applied, using modified Wuzhuyu Decoction (吴茱萸汤). For blood deficiency with cold congelation, unblocking and nourishing are undertaken together, using modified Danggui Sini Decoction (当归四逆汤). The ultimate goal is to restore the dynamic balance of yin, yang, qi, and blood in the body, thereby allevia-ting pain by restoring clarity and function to the head orifices.
5.WANG Qingguo's Experience in Treatment of Headache Based on the Concept of "Achieving Harmony by Unblocking and Balancing"
Chuxin ZHANG ; Zilin REN ; Yang ZHAO ; Jinhua HAN ; Bomin ZHANG ; Fafeng CHENG ; Changxiang LI ; Xueqian WANG ;
Journal of Traditional Chinese Medicine 2026;67(9):935-940
This paper summarizes professor WANG Qingguo's experience in treatment of headache based on the "achieving harmony by unblocking and balancing" concept. It is considered that although the pathogenesis of headache is generally attributed to "pain arises from obstruction" and "pain arises from malnourishment", clinical presentations often involve a complex mixture of deficiency and excess, as well as cold and heat patterns. Professor WANG proposes the diagnostic and therapeutic theory of "achieving harmony by unblocking and balancing", advocating for equal emphasis on "freeing the flow of qi and blood" and "regulating the balance of yin and yang". He has summarized eight treatment methods for common headache patterns. For wind-cold attacking the collaterals, treatment should focus on dispersing and unblocking through modified Gegen Decoction (葛根汤). For wind-dampness binding, it is recommended to unblock and drain, using modified Qingshang Juantong Decoction (清上蠲痛汤). For damp-heat congestion, unblocking and clearing is the method, using modified Toufeng Shen Formula (头风神方). For liver-gallbladder qi constraint, unblocking and soothing is the treatment principle, and modified Sanpian Decoction (散偏汤) is suggested. For insufficiency of center qi, even supplementation method is recommended, and modified Yiqi Congming Decoction (益气聪明汤) can be used. For liver yang hyperactivity, unblocking and subduing are combined, using modified Xunlong Decoction (驯龙汤). For deficiency-cold in the liver and stomach, warming, harmonizing, unblocking, and descending are applied, using modified Wuzhuyu Decoction (吴茱萸汤). For blood deficiency with cold congelation, unblocking and nourishing are undertaken together, using modified Danggui Sini Decoction (当归四逆汤). The ultimate goal is to restore the dynamic balance of yin, yang, qi, and blood in the body, thereby allevia-ting pain by restoring clarity and function to the head orifices.
6.Staged Differentiation and Treatment of Breast Cancer-Related Lymphedema Based on the Theory of "Diffusing Therapy Can Eliminate Congestion"
Jie ZHANG ; Yuansha GE ; Zilin WANG ; Jie LI
Journal of Traditional Chinese Medicine 2026;67(21):2334-2338
Grounded in the theory that "diffusing therapy can eliminate congestion", this paper proposes that "congestion" runs through the entire course of breast cancer-related lymphedema (BCRL). In treatment, the causes of congestion should be clearly differentiated, with diffusing and unblocking to promote flow and transformation as the therapeutic principle, so as to eliminate the congested state at different stages. In the early stage, stagnation of qi and dampness obstructs the vessels and collaterals, for which treatment is aimed at diffusing qi, promoting urination to drain dampness, soothing the liver and unblocking the collaterals, with modified Chaihu Shugan Powder (柴胡疏肝散) combined with Shengxian Decoction (升陷汤). In the progressive stage, exuberant phlegm and stasis cause water to flood the three jiao (焦), and the treatment is aimed at dispersing and freeing three jiao, resolving stasis and promoting diuresis, with modified Wuling Powder (五苓散) combined with Danggui Shaoyao Powder (当归芍药散). In the advanced stage, turbid toxin congeals and obstructs, with blood and water bound together; treatment is aimed at diffusing and outthrusting turbid toxin, breaking stasis and expelling water, with modified Simiao Yongan Decoction (四妙勇安汤) combined with Shengjiang Powder (升降散). Throughout the disease course, the principles of diffusing and unblocking to promote flow and transformation should be followed, with dynamic differentiation and treatment according to the three stages, in order to provide a theoretical reference for the clinical management of BCRL.
7.Nursing care of a patient undergoing an abandoned liver transplantation combined with ALPPS
Yan WANG ; Wenyan PAN ; Lihong CHENG ; Zilin ZHOU ; Yancheng HU ; Xiaoyun ZHANG
Chinese Journal of Nursing 2025;60(9):1128-1132
To summarize the nursing experience of a patient who underwent an abandoned liver transplantation combined with associating liver partition and portal vein ligation for staged hepatectomy.The main points of nursing included the establishment of a multidisciplinary team before surgery to ensure the smooth progress of the surgery,intraoperative preservation of the abandoned liver and healthcare collaboration for precise portal vein pressure monitoring,postoperative implementation of capacity management for ensuring perfusion of abandoned liver,dynamic monitoring of abandoned liver hyperplasia and prevention of small liver syndrome,individualized immune management and prevention of acute rejection reactions,nutritional support and exercise rehabilitation,strengthening protection and isolation strategies to comprehensively reduce the risk of infection.After treatment and nursing,the patient was discharged on the 28th of surgery.
8.Paternal transmission of epigenetic information and its potential impact on offspring health
Zilin ZHENG ; Yifan ZHANG ; Bingrou GUO ; Liandong ZUO
National Journal of Andrology 2025;31(11):1027-1031
Recent studies indicate that paternal exposures significantly affect offspring health.Adverse factors such as poor diet,toxin exposure,and stress can reduce semen quality and disrupt epigenetic marks in sperm,leading to changes in off-spring traits.Paternal transgenerational inheritance mainly occurs through epigenetic factors like DNA methylation,histone modi-fication,and non-coding RNAs.While researches have begun to reveal how sperm transmits epigenetic information,paternal epi-genetics largely remains correlational.Increasing concerns about environmental pollution and lifestyle changes have shifted focus to paternal sperm quality and its impact on offspring health before conception.Future studies should explore how different envi-ronmental and male infertility factors influence paternal epigenetics and how specific marks affect embryonic development,ulti-mately enhancing diagnostics,treatments,and preconception care.
9.A bidirectional two-sample Mendelian randomization study on causal relationship between major depression disorder,anxiety disorders and cancers
Yuliang ZHANG ; Ming ZHANG ; Long YANG ; Zirong LIU ; Rui FENG ; Chunqiang LI ; Zilin CUI
Chinese Mental Health Journal 2025;39(11):929-936
Objective:To explore the potential causal relationships between major depressive disorder(MDD),anxiety disorder(AD)and various highly prevalent cancers from the genetic perspective.Methods:Sum-mary statistics from large-scale genome-wide association studies(GW AS)were analyzed using a bidirectional two-sample Mendelian randomization(MR)approach.The inverse variance weighting method(IVW)was usedas the main analytical approach.The intercept term of MR-Egger regression and the MR-PRESSO method were adopted for the pleiotropy test.Results:The IVW analysis revealed potential causal relationships between MDD and breast cancer[OR(95%CI):1.11(1.01-1.22),P<0.05],AD and lung cancer[OR(95%CI):1.30(1.02-1.65),P<0.05],and between colon cancer and MDD[OR(95%CI):1.05(1.00-1.11),P<0.05].The results of the pleiotropy test showed that the intercept terms of the MR-Egger regression were not statistically significant,indica-ting the absence of pleiotropy.The MR-PRESSO method detected outliers only in the relationship between MDD and breast cancer.The association between MDD and breast cancer remained significant after correction for outliers[OR(95%CI):1.10(1.03-1.17),P<0.05].Conclusion:The study suggests that MDD may be a risk factor for breast cancer,AD may increase the risk factor for lung cancer,and colon cancer may elevate the risk factor of MDD.Moreover,the possibility of reverse causal relationships has been excluded in all these cases.
10.A bidirectional two-sample Mendelian randomization study on causal relationship between major depression disorder,anxiety disorders and cancers
Yuliang ZHANG ; Ming ZHANG ; Long YANG ; Zirong LIU ; Rui FENG ; Chunqiang LI ; Zilin CUI
Chinese Mental Health Journal 2025;39(11):929-936
Objective:To explore the potential causal relationships between major depressive disorder(MDD),anxiety disorder(AD)and various highly prevalent cancers from the genetic perspective.Methods:Sum-mary statistics from large-scale genome-wide association studies(GW AS)were analyzed using a bidirectional two-sample Mendelian randomization(MR)approach.The inverse variance weighting method(IVW)was usedas the main analytical approach.The intercept term of MR-Egger regression and the MR-PRESSO method were adopted for the pleiotropy test.Results:The IVW analysis revealed potential causal relationships between MDD and breast cancer[OR(95%CI):1.11(1.01-1.22),P<0.05],AD and lung cancer[OR(95%CI):1.30(1.02-1.65),P<0.05],and between colon cancer and MDD[OR(95%CI):1.05(1.00-1.11),P<0.05].The results of the pleiotropy test showed that the intercept terms of the MR-Egger regression were not statistically significant,indica-ting the absence of pleiotropy.The MR-PRESSO method detected outliers only in the relationship between MDD and breast cancer.The association between MDD and breast cancer remained significant after correction for outliers[OR(95%CI):1.10(1.03-1.17),P<0.05].Conclusion:The study suggests that MDD may be a risk factor for breast cancer,AD may increase the risk factor for lung cancer,and colon cancer may elevate the risk factor of MDD.Moreover,the possibility of reverse causal relationships has been excluded in all these cases.

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