1.Efficacy and Mechanism of Action of Ermiao Situ Decoction in Modulating JAK/STAT Pathway in Rats with Damp-heat Eczema
Kangning HAN ; Junjie HU ; Juan LI ; Min ZHANG ; Xian ZHOU ; Songlin LIU ; Xin CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):37-47
ObjectiveUltra performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry (UPLC-Q-TOF-MS/MS) coupled with network pharmacology and molecular docking was utilized to explore the efficacy and mechanism of action of Ermiao Situ decoction on rats with damp-heat eczema. MethodsA rat model of damp-heat eczema was established by artificial climate chamber intervention combined with sensitization induction by dinitrochlorobenzene (DNCB), and it was randomly divided into the normal group, the model group, the medium- and high-dose groups of Ermiao Situ decoction (3.40 g·kg-1 and 6.80 g·kg-1), and the prednisone acetate group (2.51 mg·kg-1), with eight rats in each group, totalling 46 rats, of which six rats were tested with the drug-containing serum. The chemical analysis of drug-containing serum from rats was carried out by UPLC-Q-TOF-MS/MS, combined with network pharmacology for the prediction of key components, core targets, and signaling pathways, and molecular docking experiments were performed by CB-Dock2 online website. The pharmacological effects of Ermiao Situ decoction in the treatment of damp-heat eczema were investigated by epitaxial indexes combined with the pathologic tissue staining method. The serum levels of gastrin (GAS), interleukin-4 (IL-4), and interleukin-13 (IL-13) were measured by enzyme-linked immunosorbent assay (ELISA). Interleukin-6 (IL-6), Janus kinase 1 (JAK1), phosphorylated (p)-JAK1, signal transduction and activation of transcription factor 3 (STAT3), and p-STAT3 protein expression level was determined by Western bolt. ResultsA total of 19 active ingredients were detected in drug-containing serum samples of rats, which were predicted to act on 198 targets for the treatment of damp-heat eczema, among which the key ingredients included rhodopsin, huangpai alkaloids, and quercetin, and the main core targets included STAT3, tumor necrosis factor (TNF), and IL-6, which were mainly involved in the cancer signaling pathway, phosphatidylinositol 3-kinase (PI3K)/protein kinase (Akt) signaling pathway, T helper 17 (Th17) cell differentiation signaling pathway, and JAK/STAT signaling pathway. The molecular docking results suggested that the key components had strong binding activities with the core targets IL-6, JAK1, and STAT3 in the JAK/STAT signaling pathway. The results of animal experiments showed that compared with those in the normal group, rats in the model group were depressed. They had loose hair, loose stools, epidermal oozing, vesiculation, and generation of thick scabs in the form of scales, decreased body weight, increased anus temperature and water intake, and increased indexes of the spleen, thymus gland, and stomach (P<0.05, P<0.01), and the lesion tissue could be seen to be hyperkeratotic, with the aggregation of inflammatory cells and nonsignificant separation of epidermis and dermis. The gastric mucosa was thinned, deficient, and structurally disorganized, and obvious inflammatory cell aggregation was seen. The levels of GAS, IL-4, and IL-13 in serum were significantly reduced (P<0.05, P<0.01), and the protein expression levels of IL-6, JAK1, p-JAK1, and p-STAT3 in the lesion tissue were significantly increased (P<0.05, P<0.01). Compared with those in the model group, rats in each administration group had stable mental states, formed feces, a clean perianal area, and basically normal epidermis. Only a small amount of scaly scabs existed, and the rats had body weight increased, with decreased anal temperature and water intake, as well as decreased spleen, thymus, and gastric indexes (P<0.05, P<0.01). Epidermal thickness was decreased, and epidermal and dermal separation boundaries were obvious, but hyperkeratotic and accumulation of inflammatory cells could still be seen. The thickness of gastric mucosa increased, and the structure was restored to varying degrees. The levels of GAS, IL-4, and IL-13 content in the serum of rats were increased to varying degrees, and the protein expression levels of IL-6, JAK1, p-JAK1, and p-STAT3 in the dermal lesion tissue were significantly decreased (P<0.05, P<0.01). ConclusionErmiao Situ decoction may exert therapeutic effects on rats with damp-heat eczema by modulating the JAK/STAT signaling pathway.
2.Ginsenoside Rg2 Protects Heart After Acute Myocardial Infarction by Regulating PI3K/Akt/mTOR Signaling Pathway
Xixian ZHANG ; Junjie SUN ; Qingya LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):185-193
ObjectiveTo investigate the cardioprotective effects of ginsenoside Rg2 in regulating the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway following acute myocardial infarction (AMI) in rats. Methods(1) Cellular experiment: Cardiomyocytes were isolated from 24-hour-old Sprague-Dawley (SD) neonatal rats and subjected to primary culture. An in vitro model of cardiomyocytes under an ischemic-hypoxic microenvironment was established. Cardiomyocytes were pretreated with ginsenoside Rg2 (1, 2, 3 mg·L-1) for 4 hours, then placed in RPMI 1640 serum-free medium and cultured for 24 hours in a three-gas incubator (94% N2, 5% CO2, 1% O2). The survival rate of cardiomyocytes was assessed using the methyl thiazolyl terazolium (MTT) assay. The levels of lactate dehydrogenase (LDH) leakage, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, and malondialdehyde (MDA) content in the cell culture supernatant were measured using spectrophotometry. (2) Animal experiment: Specific-pathogen-free (SPF) SD rats were used to establish an AMI model using the Olivette method combined with previous studies. Rats that survived 24 hours post-surgery were randomly divided into a model group and ginsenoside Rg2 high-, medium-, and low-dose groups. The normal and model groups received normal saline, while the ginsenoside Rg2 groups were administered intragastrically at doses of 8, 4, and 2 mg·kg-1, once daily for 3 days. The levels of SOD, MDA, and GSH-Px in myocardial tissues were detected. Cardiomyocyte apoptosis was assessed using the TdT-mediated dUTP biotin nick end labeling (TUNEL) assay. The mRNA and protein expression levels of PI3K, Akt, mTOR, p62, nuclear factor-κB p65 (NF-κB p65), and microtubule-associated protein 1 light chain 3 (LC3) Ⅱ/Ⅰ in myocardial tissues were analyzed using real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot. Pathological changes in the infarct border zone were observed under a light microscope. Results(1) Cellular experiment: Compared with the normal group, the model group exhibited a significantly decreased cardiomyocyte survival rate, as well as reduced SOD and GSH-Px activity, whereas LDH activity and MDA content were significantly increased (P<0.05). Compared with the model group, ginsenoside Rg2 intervention significantly increased cardiomyocyte survival, SOD activity, and GSH-Px activity, while reducing LDH activity and MDA content (P<0.05) in a dose-dependent manner. Pathological examination revealed that ginsenoside Rg2 alleviated infarct size, myocardial degeneration, and necrosis, while significantly reducing cardiomyocyte apoptosis. (2) Animal experiment: Compared with the normal group, the model group exhibited significantly lower SOD and GSH-Px activity (P<0.05) and higher MDA content (P<0.05) in myocardial tissues. Compared with the model group, all ginsenoside Rg2 groups showed significantly increased SOD and GSH-Px activity (P<0.05) and reduced MDA content (P<0.05). Compared with the normal group, the model group exhibited significantly decreased mRNA and protein expression levels of PI3K, Akt, mTOR, p62,and LC3 Ⅱ/Ⅰ,whereas the expression levels of NF-κB p65 were significantly increased (P<0.05). Compared with the model group, the ginsenoside Rg2 groups showed significantly increased PI3K, Akt, mTOR, and p62 expression, while NF-κB p65 expression levels were significantly decreased (P<0.05) in a dose-dependent manner,the mRNA and protein expression levels of LC3 Ⅱ/Ⅰ in ginsenoside Rg2 high-dose groups were significantly increased(P<0.05). ConclusionGinsenoside Rg2 exerts cardioprotective effects following AMI in rats, potentially through the regulation of PI3K/Akt/mTOR-related protein expression.
3.Exploration of the antidepressant machanism of Shugan hewei tang based on metabolomics of PFC-NAc-VTA neural circuit
Xinyue QU ; Junjie HU ; Juan LI ; Min ZHANG ; Xian ZHOU ; Songlin LIU ; Xin CHEN
China Pharmacy 2025;36(10):1172-1178
OBJECTIVE To investigate the antidepressant mechanism of Shugan hewei tang (SGHWT) based on the metabolomics of prefrontal cortex (PFC)-nucleus accumbens (NAc)-ventral tegmental area (VTA) neural circuit. METHODS Male SD rats were randomly divided into blank group, model group, SGHWT low-, medium- and high-dose groups [3.67, 7.34, 14.68 g/(kg·d), by raw material], and fluoxetine group [1.58 mg/(kg·d), positive control], with 12 rats in each group. Except for the blank group, the depression model was established by chronic unpredictable mild stress combined with individual cage housing in the remaining groups, and the corresponding drug solution or normal saline was administered via gavage during modeling, once a day, for 6 consecutive weeks. After the last administration, the body weight, sucrose preference rate, total moving distance, frequency into the center and immobility time of rats in each group were detected. Samples of PFC, NAc and VTA areas of rats in the blank group, model group, SGHWT medium-dose group and fluoxetine positive control groups were collected,and their histomorphological features were observed, and non-targeted metabolomics analysis (except for fluoxetine group)were performed and validated. RESULTS Compared with model group, the cytolysis, structural damage and other pathological damages in three brain regions of rats were significantly alleviated in each drug group, while their body weight, sucrose preference rate, total moving distance and frequency into the center were all significantly higher or longer (P<0.05), and immobility time was significantly shorter (P<0.05). The results of non-targeted metabolomics showed that a total of 78 endogenous differential metabolites were identified, with 40, 35 and 24 in the PFC, NAc and VTA regions respectively, mainly involved in amino acid, lipid and sphingolipid metabolism. The results of metabolic pathway enrichment analysis showed that SGHWT affected the neural circuits of depressed rats by regulating sphingolipid metabolism, alanine, aspartic acid and glutamic acid metabolism, saturated fatty acid biosynthesis, among which alanine, aspartic acid and glutamic acid metabolism was predominantly involved. Validation experiments showed that SGHWT significantly increased the phosphorylation levels of protein kinase B (Akt) and mammalian target of rapamycin (mTOR), and decreased the protein expression of N-methyl-D-aspartic acid receptor 1 (NMDAR1) in the NAc region of rats. CONCLUSIONS SGHWT significantly improves the depression-like behavior and attenuates pathological damage of PFC-NAc-VTA neural circuit of model rats, the mechanism of which is associated with inhibiting NMDAR1 expression and activating the Akt/mTOR signaling pathway.
4.Design, synthesis and anticancer activity of superoxide anion-releasing beta-galactoside prodrugs
Jiaxuan LIU ; Xueyan YAO ; Yunying TAN ; Jing HU ; Junjie FU ; Jian YIN
Journal of China Pharmaceutical University 2025;56(3):295-304
Four novel β-galactoside prodrugs were designed and synthesized from anthraquinones HAQ-OH and AQ-OH in an attempt to use the prodrugs to selectively release superoxide anion (O2−) in cancer cells and to achieve selected anticancer activity by utilizing the Warburg effect and the elevated level of β-galactosidase in certain cancer cells. Cellular assays showed that the prodrugs Gal-HAQ and Gal-AQ selectively inhibited the proliferation and induced apoptosis of ovarian cancer OVCAR-3 cells overexpressing β-galactosidase. Using O2− fluorescent probe, it was found that in OVCAR-3 cells Gal-HAQ and Gal-AQ could time-dependently release O2−, which was essential for their anticancer activity. Furthermore, it was found that Gal-HAQ and Gal-AQ were effective senolytics toward senescent cells overexpressing β-galactosidase without affecting the viability of corresponding non-senescent cells, further confirming the β-galactosidase-dependent cytotoxicity of the prodrugs. In conclusion, Gal-HAQ and Gal-AQ, which release O2− in response to β-galactosidase, are expected to serve as candidate prodrugs targeting cancer cells.
5.Comparison of the efficacy of remimazolam and propofol in the induction and maintenance of general anesthesia in elderly patients undergoing thoracoscopic lobectomy
Chun LIU ; Juan HU ; Yu HUANG ; Jinqiu YANG ; Junjie LI ; Ping YANG ; Pengfei PAN
China Pharmacy 2025;36(16):2040-2045
OBJECTIVE To compare the clinical efficacy and safety of remimazolam and propofol in general anesthesia induction and maintenance for elderly patients undergoing thoracoscopic lobectomy. METHODS A total of 86 elderly lung cancer patients who underwent thoracoscopic lobectomy at Chongqing University Three Gorges Hospital from February to July 2024 were selected and divided into the propofol group and the remimazolam group according to the randomized numerical table method, with 43 cases in each group. During anesthesia induction, patients in the propofol group and the remimazolam group were intravenously administered 2 mg/kg of Propofol medium- and long-chain fat emulsion injection or 0.25 mg/kg of Remimazolam tosilate for injection, respectively; during anesthesia maintenance, the two groups received intravenous infusion of 6-10 mg/(kg·h) of Propofol medium- and long- chain fat emulsion injection or 1-3 mg/(kg·h) of Remimazolam tosilate for injection, respectively. The anesthesia effects, anesthesia-related indicators, intraoperative opioid and muscle relaxant dosages, Ramsay sedation score, numerical rating scale (NRS) score, and hemodynamic parameters were compared between the two groups, and the occurrence of adverse drug reactions was recorded. RESULTS A total of 41 patients in the propofol group and 43 patients in the remimazolam group completed the trial. The proportion of patients with grade Ⅰ anesthesia effect in the remimazolam group was significantly higher than that in the propofol group, while the proportion of patients with grade Ⅱ anesthesia effect was significantly lower than that in the propofol group (P<0.05). In this group, the disappearance time of eyelash reflex, the time taken for the bispectral index to drop to 60, and the Ramsay sedation scores (2 and 6 hours after operation) were all significantly prolonged or increased, while the recovery time, NRS scores (2 and 6 hours after operation), and the incidence of intraoperative hypotension were all significantly shortened or reduced; moreover, the improvements of the above sedation/NRS scores exhibited a time-dependent pattern within 2 to 24 hours after operation (P<0.05). Compared with before anesthesia induction (T0), the heart rate [except at 2 min after medication (T1), 60 min after anesthesia (T4), and at the end of surgery (T5) in the remimazolam group] and mean arterial pressure [except at T1 in the remimazolam group] of patients in both groups significantly decreased at T1, 5 min after medication (T2), at the start of surgery (T3), T4, and T5 (P<0.05). Meanwhile, regional cerebral oxygen saturation significantly increased in both groups. Furthermore, the heart rate and mean arterial pressure of patients in the remimazolam group were significantly higher than those in the propofol group at T1, T2 and T4 (P<0.05). No statistically significant differences were observed between the two groups in terms of postanesthesia care unit stay time, dosage of opioids and muscle relaxants, regional cerebral oxygen saturation, or peripheral oxygen saturation at various time points (P>0.05). CONCLUSIONS Compared to propofol, remimazolam demonstrates superior anesthesia effects when used for the induction and maintenance of general anesthesia in elderly patients undergoing thoracoscopic lobectomy. It not only provides more stable intraoperative hemodynamics and shortens the postoperative recovery time but also effectively reduces the incidence of intraoperative hypotension.
6.Wolbachia infection and genotyping in Aedes albopictus
Xihong LYU ; Chi ZHANG ; Xuefei QIAO ; Fei WANG ; Junjie TAO ; Bowen PANG ; Hongxia LIU
Shanghai Journal of Preventive Medicine 2024;36(1):30-35
ObjectiveTo investigate the infection and genotypes of Wolbachia in Aedes albopictus. MethodsAdult and larval samples of Aedes albopictus were collected from different residential and wild areas from 2020 to 2021, Wolbachia surface protein (wsp) gene was amplified and genotyped for wAlbA and wAlbB by PCR, and sequenced for phylogenetic analysis. The difference of detection rate among different habitats, male and female adult mosquitoes, adult and larvae was compared by χ2 analysis. ResultsThe detection rate of Wolbachia in adult and larvae of Aedes albopictus were 43.5% (77/177) and 70.4% (190/270), respectively, with a statistically significant difference (χ2=32.086,P<0.001), and wAlbA and wAlbB were mainly detected together. The detection rate of Wolbachia in female and male Aedes albopictus were 50.7% (76/150) and 3.7% (1/27), respectively, with a statistically significant difference(χ2=20.533,P<0.001). The detection rate of adult Aedes albopictus in Songjiang wild area, residential area and Hongkou residential area were 91.7% (55/60), 18.8% (22/117) and 41.7% (30/72), respectively, with a statistically significant difference (χ2=54.322,P<0.001). Genotyping and phylogenetic analysis showed that adult and larvae of Aedes albopictus infected with Wolbachia were mainly wAlb A and wAlb B. In addition, some sequences formed clades independently, and the genetic distance from other sequences was relatively large. ConclusionInfection of Wolbachia in Aedes albopictus is relatively common in Songjiang District. The main genotypes are wAlb A and wAlb B and there may be other subtypes, which are worthy of further exploration and research.
7.Effect of Qihuang Jianpi Zishen Granules on STAT3/mTOR Signaling Pathway in Patients with Systemic Lupus Erythematosus
Zhongfu TANG ; Chuanbing HUANG ; Lili CHENG ; Junjie CHEN ; Shuangshuang SHANG ; Ming LI ; Sidi LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(8):118-125
ObjectiveTo investigate the clinical efficacy of Qihuang Jianpi Zishen Granules in the treatment of systemic lupus erythematosus (SLE) and its effect on the signal transducer and activator of tranSCription 3/mammalian target of rapamycin (STAT3/mTOR) signaling pathway, and to decipher the possible mechanism. MethodSixty female SLE patients who met the criteria in the First Affiliated Hospital of Anhui University of Chinese Medicine from May 2022 to May 2023 were selected and randomized into a control group and an observation group (30 cases in each group). The control group was treated with prednisone acetate + hydroxychloroquine sulfate orally, and the observation group was additionally treated with Qihuang Jianpi Zishen granules. The treatment lasted for 8 weeks. The SLE disease activity (SLEDAI), TCM syndrome score, erythrocyte sedimentation rate (ESR), hypersensitive C-reactive protein (hs-CRP), immune indexes [immunoglobulin G (IgG), C3, C4, CD4+, and CD8+], interleukin (IL)-17, IL-23, interferon (IFN)-γ, 24 h urinary protein (24 h PRO), serum creatinine (SCr), and expression of proteins [STAT3, phosphorylated (p)-STAT3, mTOR protein and STAT3,mTOR mRNA] in the STAT3/mTOR signaling pathway were determined before and after treatment. In addition, the adverse reactions were recorded. ResultAfter 8 weeks of treatment, the total response rate in the observation group was 93.33% (28/30), which was higher than that (70.00%, 21/30) in the control group (χ2=4.007, P<0.05). After treatment, both groups showed declined SLEDAI, TCM syndrome score, ESR, hs-CRP, IgG, CD8+, IL-17, IL-23, IFN-γ, 24 h PRO, SCr, and expression of proteins in the STAT3/mTOR pathway (P<0.01) and elevated levels of C3, C4, and CD4+ (P<0.01). Moreover, the observation group had lower SLEDAI, TCM syndrome score, ESR, hs-CRP, IgG, CD8+, IL-17, IL-23, IFN-γ, 24 h PRO, SCr, and expression of proteins in the STAT3/mTOR pathway (P<0.05, P<0.01) and higher levels of C3, C4, and CD4+ (P<0.05, P<0.01) than the control group after treatment. Neither group showed serious adverse reactions during the treatment period. ConclusionQihuang Jianpi Zishen Granules can ameliorate the inflammatory response, reduce the disease activity, and mitigate the kidney injury in SLE by inhibiting the STAT3/mTOR signaling pathway to regulate the immune function.
8.Latest research progress in airway stenosis after lung transplantation
Yujie ZUO ; Menggen LIU ; Jiaxin WAN ; Yuxuan CHEN ; Wenlong HU ; Junjie ZHANG ; Yuyang MAO ; Jing CHEN ; Ailing ZHONG ; Lingzhi SHI ; Bo WU ; Chunrong JU ; Dong TIAN
Organ Transplantation 2024;15(3):474-478
With the optimization of surgical technologies and postoperative management regimens, the number of lung transplantation has been significantly increased, which has become an important treatment for patients with end-stage lung disease. However, due to the impact of comprehensive factors, such as bronchial ischemia and immunosuppression, the incidence of airway stenosis after lung transplantation is relatively high, which severely affects postoperative survival and quality of life of lung transplant recipients. In recent years, with the improvement of perioperative management, organ preservation and surgical technologies, the incidence of airway stenosis after lung transplantation has been declined, but it remains at a high level. Early diagnosis and timely intervention play a significant role in enhancing clinical prognosis of patients with airway stenosis. In this article, the general conditions, diagnosis, treatment and prevention of airway stenosis after lung transplantation were reviewed, aiming to provide reference for comprehensive management of airway stenosis after lung transplantation and improving clinical prognosis of lung transplant recipients.
9.Comparative study on the clinical efficacy of intermittent oral administration of fosfomycin trometamol for a long time after removal of upper urinary infection stones
Huiqian LIU ; Ning WANG ; Junjie YAO ; Zhenyu LIU ; Zhikang YIN
Chongqing Medicine 2024;53(5):717-722
Objective To investigate the clinical efficacy and safety of long-term intermittent oral ad-ministration of fosfomycin trometamol(FMT)in the control of urinary tract infection and the reduction of stone recurrence rate after removal of upper urinary infection stones.Methods A total of 171 patients who met the inclusion criteria were enrolled and divided into the FMT group(using FMT),cephalosporin group(using cefixime),and blank group(not using antibiotics)according to the random number method,with 57 cases in each group.Finally,55 cases in the FMT group,47 cases in the cephalosporin group and 48 cases in the blank group were included in the statistical analysis,and the urinary tract infection and stone recurrence of the three groups were followed up regularly after the stone removal operation.Results There was no statisti-cal significance in the baseline data of the three groups(P>0.05).There were significant differences in the recurrence rate of urinary tract infection at the 3rd and 6th month among the 3 groups(P=0.010,P<0.001).Further pair-wise comparison showed that the recurrence rate of urinary tract infection at the 3rd month in the FMT group was lower than that in the blank group(P<0.05),but there was no statistical difference compared with the cephalosporin group(P>0.05).The recurrence rate of urinary tract infection at the 6th month in the FMT group was lower than that in the cephalosporin group and blank group(P<0.05).The recurrence rate of stones in the 1st and 3rd year of the three groups were statistically different(P= 0.028,0.015).Further pair-wise comparison showed that the 1st year stone recurrence rate of the FMT group was lower than that of the cephalosporin group and blank group(P<0.05).The 3rd year stone recurrence rate of the FMT group was lower than that of the blank group(P<0.05),but there was no statistical difference compared with the cephalosporin group(P>0.05).There was no significant difference in the total incidence of adverse drug re-action between the FMT group and cephalosporin group(P=0.131).Conclusion FMT is superior to cephalospo-rin in the control of urinary tract infection after lithotripsy for upper urinary tract infection.
10.Hemodynamic simulation study of tandem carotid artery stenosis
Junjie CAO ; Zhichao YAO ; Guijun HUO ; Zhanao LIU ; Yao TANG ; Jian HUANG ; Dayong ZHOU ; Liming SHEN
Journal of Interventional Radiology 2024;33(2):150-155
Objective By using the computational fluid mechanic(CFD)method the tandem carotid artery stenosis(TCAS)was simulated on the model,and to compare the postoperative hemodynamic changes of different surgical procedures.Methods One patient with tandem stenosis of internal carotid artery(ICA)and common carotid artery(CCA)was selected.CFD technique was used to establish four three-dimensional(3-D)models of the carotid bifurcations,including one model of a real patient and three models of presumptive surgery.The hemodynamic analysis was performed with these models so as to explore the development mechanism of TCAS and to discuss the selection of suitable surgical plan.Results In tandem stenosis,the stenosis was preferentially formed in CCA and subsequently led to ICA stenosis.The local hemodynamic situation in TCAS was more complex and more risky than in single carotid artery stenosis.In tandem stenosis,the treatment of one stenosis site would affect the blood flow at the next stenosis site and cause restenosis or plaque rupture.Conclusion In treating patients with TCAS,CFD simulation examination should be performed when the surgical plan is formulated,which can help clinicians to predict the postoperative changes in blood flow and to choose the appropriate surgical plan.

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