1.Clinical Observation on Prevention of Recurrence of Common Bile Duct Stones After ERCP with Yuyin Lidan Granules
Xiao WANG ; Yong FANG ; Cong HE ; Jiali ZHANG ; Meng YU ; Jing KONG ; Yi JIANG ; Chuanqi CHENG ; Xiaosu WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):159-166
ObjectiveTo observe the clinical efficacy and safety of Yuyin Lidan granules (YYLD) in preventing the recurrence of common bile duct stones (CBDS) in patients with liver and gallbladder dampness-heat syndrome following endoscopic retrograde cholangiopancreatography (ERCP). MethodsThis randomized, parallel, controlled trial enrolled postoperative CBDS-ERCP patients who met the inclusion and exclusion criteria. Sixty-four patients were randomly assigned to an observation group or a control group, with 32 cases in each. Both groups received conventional Western medical treatment after ERCP, while the observation group additionally received YYLD for 8 weeks. The follow-up period lasted for 1 year. The efficacy indicators included bile bilirubin levels, traditional Chinese medicine (TCM) syndrome scores, clinical efficacy rate, pancreatitis and inflammation markers, postoperative liver function, and CBDS recurrence rate at 1-year follow-up, which were used to jointly evaluate the clinical efficacy and safety of both groups. ResultsA total of 56 patients completed the study and were included in the final analysis, i.e., 29 in the observation group and 27 in the control group. Baseline characteristics were comparable between the two groups. Compared with pre-treatment and with the control group after treatment, the bile bilirubin level in the observation group significantly decreased (P<0.05). After treatment, the clinical cure and marked improvement rates were higher in the observation group than in the control group, showing a statistically significant difference in overall clinical efficacy (P<0.05). Compared with pre-treatment, the primary and secondary symptoms in the observation group, as well as the primary symptom and the secondary symptom of nausea and vomiting in the control group (weeks 4 and 8), were significantly reduced (P<0.05). Compared with the control group after treatment, the observation group showed significant reductions in the primary symptom of loose stools/constipation (day 5 and week 4) and in three secondary symptoms, i.e., bitter taste and sticky dry mouth, abdominal distension and poor appetite (throughout the treatment period), and general heaviness and fatigue (day 5 and week 4), with statistical differences (P<0.05). Compared with pre-treatment, both groups showed decreased lipase and urinary amylase levels (P<0.05). However, no significant between-group differences were observed in pancreatitis or inflammation-related indices after treatment. Compared with pre-treatment, all liver function indicators in the observation group and alanine aminotransferase ( ALT ), γ-glutamyl transferase ( γ-GT ), alkaline phosphatase (ALP), and conjugated bilirubin in the control group significantly decreased at weeks 4 and 8 (P<0.05). Compared with the control group after treatment, only serum total bilirubin and unconjugated bilirubin were significantly reduced in the observation group during the treatment period (P<0.05). ConclusionYYLD combined with conventional Western medical treatment can effectively regulate bilirubin metabolism (in bile and serum), improve TCM clinical symptoms, and prevent CBDS recurrence after ERCP in patients with liver and gallbladder dampness-heat syndrome. This regimen is safe and effective and is worthy of further clinical research and promotion.
2.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.
3.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.
4.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.
5.Clinical Application of Harmonizing and Regulating Pivot Method in Pulmonary Fibrosis:Based on the Characteristics of Essence-Attribute-Function
Mingsheng LYU ; Hongsheng CUI ; Jia ZHU ; Weibo BI ; Ruifeng JIN ; Zhijie ZHANG ; Qiuyi CHEN ; Siyang YU
Journal of Traditional Chinese Medicine 2026;67(4):381-385
Based on the theory of "shaoyang(少阳) resembling the pivot" and collateral diseases, this article proposes that pulmonary fibrosis (PF) can be divided into three stages including wind bi (痹), constraint bi, and atrophy bi. The core pathogenesis of PF is the obstruction of the pivot and pulmonary collateral obstruction. In terms of treatment, the basic principles are to harmonize and regulate the pivot, and to promote the circulation of the lung collaterals. Depending on the different characteristics of the "essence-attribute-function", treatment methods such as harmonizing and regulating the pivot, resolving phlegm and removing stasis, supplementing deficiency and harmonizing collaterals are suggested. This approach ensures the regulation of the pivot, smooth circulation of qi and blood, unblocking of the lung collaterals and nourishing the lung body, achieving the goals of balancing the ascending and descending of qi, removing phlegm and stasis, and relieving cough and wheezing.
6.Epidemiological characteristics and disease burden of liver cancer in Guangdong Province
Ying ZHANG ; Yixuan CHEN ; Rong CAO ; Yue GAO ; Yutong HAN ; Ye WANG ; Ruilin MENG ; Xueyan ZHENG ; Yu LIAO ; Zhuanping ZENG
Journal of Public Health and Preventive Medicine 2026;37(1):68-72
Objective To analyze the epidemiological characteristics and disease burden of liver cancer in Guangdong Province in 2020, and to provide a scientific foundation for the development of regionalized prevention and control strategies for liver cancer. Methods According to the cancer registry data of Guangdong Province, the incidence, mortality and age-standardized rate by Chinese standard population in 2020 were calculated to analyze the epidemiological characteristics of liver cancer. The disability adjusted life years (DALYs), year of life loss (YLL), year of lived with disability (YLD), and cause-eliminated life expectancy were used to assess the disease burden of liver cancer. Results In 2020, the crude incidence rate and the age-standardized incidence rate of liver cancer in Guangdong Province were 27.79/100 000 and 20.84/100 000,respectively, and the crude mortality rate and the age-standardized mortality rate of liver cancer were 25.49/100,000 and 17.64/100 000, respectively. The total DALY and DALY rate of liver cancer in Guangdong Province were 515 311 person-years and 513.83/100 000, respectively. After eliminating the causes of death from liver cancer, the life expectancy in Guangdong Province increased from 84.60 years to 84.99 years. All indicators consistently demonstrated that the burden of liver cancer was higher in males than that in females, and the burden of liver cancer was higher in rural areas than that in urban areas. Conclusion Liver cancer in Guangdong Province exhibits a high incidence, mortality and disease burden level in 2020. There are obvious differences of gender, age and region in cancer burden. It is necessary to strengthen liver cancer screening and diagnosis and treatment in men, the elderly and those in rural areas to reduce the burden of liver cancer gradually in Guangdong Province.
7.Culture and identification of rat corpus cavernosum smooth muscle cells by modified tissue block adherence method
Tao ZHANG ; Maobin YU ; Meijun LIU ; Ziyang MA ; Peihai ZHANG
Acta Universitatis Medicinalis Anhui 2026;61(1):113-117
ObjectiveTo establish an in vitro culture model of rat corpora cavernous smooth muscle cells (CCSMCs) using a modified tissue block adherence method. MethodsCorpus cavernosum smooth muscle tissue was digested with collagenase type I and subsequently cultured using an adherent method. Cells were purified via differential adhesion and identified through immunofluorescence and Western blotting. ResultsCCSMCs began to emerge from the tissue block after 3 days, increased significantly by day 7, and converged by day 12. Post-passage, CCSMCs exhibited strong proliferation and a “peak-to-valley” phenomenon. After purification, the cells tested positive for α-smooth muscle actin (α-SMA), confirming the successful establishment of the in vitro culture model. ConclusionThe modified tissue block adherence method is a cost-effective and efficient way to obtain high-purity CCSMCs.
8.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.
9.Drug comprehensive value assessment frameworks for medical insurance:overseas experiences and implications for China
Yijun LIU ; Dan LI ; Yu ZHANG ; Bin JIANG
China Pharmacy 2026;37(4):413-419
OBJECTIVE To systematically compare mature experiences of comprehensive drug value assessment in typical countries/regions and to provide decision-making references for China to establish a scientific and standardized comprehensive drug value assessment system for medical-insured drugs. METHODS The literature analysis was used to systematically review drug value assessment frameworks in 11 representative countries/regions, namely the UK, Canada, Italy, Australia, Germany, France, South Korea, Japan, the United States, as well as Taiwan (China) and Hong Kong (China). Comparisons were made across three dimensions: assessment entities, value dimension, and application of results. RESULTS &CONCLUSIONS In most countries/regions, independent technical assessment institutions have been established as part of the drug value evaluation system, with the involvement of multiple stakeholders (e.g., the UK, Canada). The mainstream drug value assessment frameworks have generally transcended the traditional core dimensions of safety, efficacy, and cost-effectiveness, exhibiting two major trends: the continuous expansion of assessment dimensions and stricter evidence requirements. Assessment outcomes are closely integrated with payment policies, ranging from providing technical advice for decision-making (e.g., Italy, France) to directly determining reimbursement eligibility (e.g., the UK, Germany). The following recommendations are proposed for China: first, establish an evaluation mechanism featuring multi-stakeholder participation and separation of evaluation from decision-making. Second, develop a comprehensive evaluation framework integrating clinical, economic, patient, and societal value, emphasizing quantitative indicator exploration and real-world evidence application. Third, promote direct linkage between value-based tiering outcomes and medical insurance reimbursement decisions or access negotiations to balance patient benefits, fund sustainability, and industrial innovation.
10.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.


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