1.Postoperative Stage-based Functional Protection Strategies for Lung Cancer Based on Theory of "Lungs Governing Qi"
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Wei HOU ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):86-93
		                        		
		                        			
		                        			Lung cancer (LC) is a significant global public health issue, with both its incidence and mortality rates ranking among the highest worldwide. The age-standardized incidence and mortality rates are increasing annually, posing a serious threat to the life and health of LC patients. Radical surgical resection is the primary treatment for malignant lung tumors. However, postoperative multidimensional functional impairments, including respiratory, mucosal, and psychological functions, are common. These impairments not only reduce patients' quality of life and affect their treatment tolerance and duration, but also negatively correlate with prognosis, facilitating disease recurrence and metastasis. At present, postoperative functional dysfunction after LC surgery remains a key clinical challenge that urgently needs to be addressed. There is a lack of standardized and regulated postoperative rehabilitation treatment management and traditional Chinese medicine (TCM) differentiation and treatment strategies for LC. Focusing on the core underlying pathogenesis of "Qi sinking" after LC surgery, and guided by the classical TCM theory of "lungs governing Qi", this study, based on the core concept of the "five perspectives on treatment" theory, innovatively proposes the respiratory dysfunction as the core pathogenesis of "Qi sinking in the chest" during the rapid rehabilitation phase, mucosal dysfunction as the core pathogenesis of "Yin deficiency and Qi sinking" during the postoperative adjuvant treatment phase, and the psychological dysfunction as the core pathogenesis of "Qi sinking with emotional constraint" during the consolidation phase. Accordingly, stage-specific dynamic functional protection strategies are constructed. In the rapid rehabilitation phase, the strategy emphasizes tonifying Qi and uplifting sinking Qi, with differentiation and treatment based on the principle of ''descending before ascending''. In the adjuvant treatment phase, the approach focuses on nourishing Yin and uplifting Qi, with prescription combinations that integrate unblocking and tonification. In the consolidation phase, the strategy aims to resolve constraint and uplift Qi, with clinical treatment emphasizing a combination of dynamic and static methods. At each stage of functional rehabilitation, clinical differentiation and treatment should support healthy Qi and eliminate pathogenic factors simultaneously. This study is the first to propose the concept of postoperative functional protection in TCM, offering a new approach for TCM differentiation and treatment in the full-cycle, stage-based, and dynamic protection of postoperative function in LC patients. It is expected to contribute to the construction and development of an integrated TCM-Western medicine comprehensive program for cancer prevention and treatment in China. 
		                        		
		                        		
		                        		
		                        	
2.A Hierarchical Strategy for Differentiation and Treatment of Recurrent Aphthous Oral Ulcers Related to Targeted Therapy for Lung Cancer Based on Yin Deficiency and Qi Collapse
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Ming LIN ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):116-125
		                        		
		                        			
		                        			Tumor treatment-related adverse reactions are a major focus of clinical concern, among which recurrent aphthous oral ulcers (RAU) associated with targeted therapy for lung cancer (LC) are among the most painful and distressing for patients. Currently, modern medical interventions show limited efficacy, and there is an urgent need for more effective treatment strategies. This study differentiates RAU associated with targeted therapy for LC from chemotherapy-related and ordinary oral ulcers, elucidates the pathophysiological basis of such ulcers, and traces the theoretical origin of "Yin deficiency and Qi collapse". Based on the new system of "five perspectives on diagnosis and treatment" for tumor prevention and treatment, with a focus on the core and symptom perspectives and rooted in the traditional concept of "lung dominating Qi", we innovatively propose the concept of "medicine-induced ulcer" and are the first to introduce the theory of "Yin deficiency and Qi collapse" into the syndrome differentiation and treatment of RAU associated with targeted therapy for LC (i.e., medicine-induced ulcer). We propose that "Yin deficiency and Qi collapse" is the core pathogenesis of medicine-induced ulcers, in which the collapse of formless Qi is the key to their onset, while the deficiency and stasis of tangible Yin and blood constitute the root of recurrence. A hierarchical strategy for syndrome differentiation and treatment is established: first treating the collapse of formless Qi, then replenishing tangible deficiencies, and concurrently preventing recurrence. We emphasize that treatment should address both root and manifestation, with appropriate prioritization. In the acute phase, while relieving symptoms and promoting ulcer healing by nourishing Qi, uplifting collapse, and generating body fluids, attention should also be paid to nourishing spleen Yin, facilitating the circulation of nutritive Qi, and alleviating stasis to target the root pathogenesis and reduce recurrence. A verified case is presented to support this approach. This study enriches the theoretical framework and clinical methods of traditional Chinese medicine (TCM) in the treatment of RAU associated with targeted therapy for LC, promotes symptom management of treatment-related adverse reactions through integrated TCM and Western medicine, and provides theoretical support for the construction and development of a comprehensive differentiation and treatment system for lung cancer prevention, treatment, and rehabilitation. 
		                        		
		                        		
		                        		
		                        	
3.Herbal Textual Research on Moschus in Famous Classical Formulas
Juanjuan LIU ; Sini LI ; Jie JI ; Liping YANG ; Houkang CAO ; Xiaohui MA ; Ling JIN ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):194-202
		                        		
		                        			
		                        			In this paper, by consulting the ancient and modern literature, the name, origin, quality evaluation, harvesting and processing, and others of the original animal and medicinal materials of Moschus were systematically sorted out and verified, in order to provide the basis for the development and utilization of the famous classical formulas containing Moschus. According to the textual research, musk deer was first recorded in Shanhaijing. Shennong Bencaojing was recorded as Moschus and all generations were used as the correct name, but there were also aliases such as Shefu, Xiangzhang and Xiangqizi. In ancient times, Moschus berezovskii, M. sifanicus and M. moschiferus were the main sources of Moschus, and the quality of Moschus produced in northwest China was better than that produced in the Yangtze River basin. In modern times, Moschus of M. moschiferus produced in northeast China, M. sifanicus produced in Gansu, Sichuan and other places, and M. berezovskii produced in Ningxia, Shaanxi and other places are regarded as genuine. In ancient times, gunshots, lassoes, arrow shots and other methods were generally used to hunt live musk deer, and the sachets were immediately cut off. Those with high quality were called Xiangshanhuo, and dried in the shade after harvesting, which was known as Maoke Shexiang. Cut open the sachet, remove the shell and dry preservation, commonly known as Moschus kernel. In modern times, the method of taking Moschus from the living body of cultured musk deer is adopted, that is, Moschus kernel is directly taken from its sachet, dried in the shade or dried in a closed dryer. This method realizes the sustainable utilization of Chinese herbal medicine resources, but attention should be paid to the frequency and quality of Moschus. The harvesting time is mostly after the autumnal equinox every year, and before the next summer, it is better to gather sachet in winter. In recent times, it is believed that the shell Moschus is dry, full, thin, elastic, loose inside, many particles, strong and persistent aroma for the best, while the Moschus kernel is particle purple-black, powder yellow-brown, soft and oily texture, strong and persistent aroma for the best. The ancient processing method of Moschus was extracting kernels from the shell. After removing impurities, it is ground and used as medicine. Because its composition is not suitable for heating, the processing method is most common in preparations such as grinding into powder and putting into pills or powders, which has the effect of opening up the orifices and refreshing the mind, and it has continued to this day. Based on the research conclusions, it is suggested that the development of famous classical formulas containing Moschus, M. sifanicus, M. moschiferus and M. berezovskii should be used as the origins. According to the processing requirements specified in the original formula, it should be processed and used as medicine, while those without processing requirements should be used as raw products. 
		                        		
		                        		
		                        		
		                        	
4.Study on component analysis,fingerprint establishment and anti-inflammatory spectrum-effect relationship of Yao ethnic medicine Pittosporum pauciflorum
Dan QIN ; Peng FU ; Jiajie CAO ; Qingchen TANG ; Jie GAO
China Pharmacy 2025;36(18):2244-2249
		                        		
		                        			
		                        			OBJECTIVE To analyze chemical components of Yao ethnic medicine Pittosporum pauciflorum, establish its fingerprint and investigate the spectrum-effect relationship of its anti-inflammatory effect. METHODS UHPLC-Q-Orbitrap-MS technology was used to analyze the chemical components of P. pauciflorum (batch S6). The fingerprints for 10 batches of P. pauciflorum from different producing areas in Guangxi Province (batches S1-S10) were established by HPLC, and similarity assessment and chemometric pattern recognition analysis were conducted. RAW264.7 inflammatory cell model was induced by lipopolysaccharide, and the anti-inflammatory activity of P. pauciflorum was investigated. Using inhibition rates of nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-1β as efficacy indicators, grey relational analysis and partial least squares regression analysis were adopted to evaluate the spectrum-effect relationship of the anti-inflammatory effect of P. pauciflorum. RESULTS There were 60 chemical components, including flavonoids, phenolic acids, lipids, etc., identified in P. pauciflorum. The fingerprints for 10 batches of P. pauciflorum showed 14 common peaks,with similarity values ranging from 0.883 to 0.991. Three common peaks were assigned neochlorogenic acid (peak 5), chlorogenic acid (peak 7), and syringaldehyde (peak 10). The classification results of the systematic clustering analysis and the principal component analysis were basically consistent. Batches S1 to S10 of P. pauciflorum significantly reduced the levels of NO, TNF-α, IL-6 (except for batch S5) and IL-1β in the cell supernatant (P<0.05 or P<0.01). Inhibition rates of above inflammatory indexes were 10.26%-39.96%, 14.96%-31.36%, 1.38%-21.27%, 18.54%-28.00%, respectively. The contents of neochlorogenic acid, syringaldehyde, as well as the components corresponding to peaks 1, 3, 9, 12 and 14,exhibited a strong correlation with the anti-inflammatory effects of P. pauciflorum. CONCLUSIONS The present study has analyzed the chemical components of P. pauciflorum and established HPLC fingerprints for 10 batches of P. pauciflorum. Each batch of medicinal herbs demonstrates certain anti- inflammatory activities, among which neochlorogenic acid, syringaldehyde, and the components corresponding to peaks 1, 3, 9, 12 and 14 are likely to be the active anti-inflammatory components.
		                        		
		                        		
		                        		
		                        	
5.Stage Treatment of Squamous Cell Carcinoma Based on the Theory of Fire and Heat
Xinyi MA ; Luchang CAO ; Xinmiao WANG ; Guanghui ZHU ; Jie LI
Journal of Traditional Chinese Medicine 2025;66(6):575-580
		                        		
		                        			
		                        			It is believed that the occurrence and development of squamous cell carcinoma (SCC) is closely associated with inflammatory responses. The theory of fire and heat, advocated by LIU Wansu, provides significant clinical guidance for understanding the pathogenesis and treatment of SCC. Based on this theory, the pathological mechanisms and clinical characteristics of SCC at different stages were analyzed. In the precancerous and early stages, the primary pathogenesis is qi stagnation leading to internal generation of constrained heat; in post-surgery, the condition shifts to qi deficiency with latent yin fire; during the treatment phase, the pathogenesis involves accumulation of pathogenic factors, excess toxins, and severe heat toxicity; in the late stage, the main pathology is yin deficiency with toxic heat, and phlegm-stasis obstruction of the internal organs. Corresponding stage-based treatment strategies are proposed. In the early stage, regulating qi movement to dissipate constrained heat; for post-surgery, tonifying qi and raising yang to dispel latent fire; during treatment stage, clearing heat and detoxifying to eliminate cancerous toxins; and in the late stage, nourishing yin and unblocking the bowels to clear deficiency heat. 
		                        		
		                        		
		                        		
		                        	
6.Research advances in the effects of orexin and its receptor-related drugs on depression
Zhaoshu JIANG ; Ming CHENG ; Jie YANG ; Feng CAO ; Zhen ZHANG
China Pharmacy 2025;36(4):496-500
		                        		
		                        			
		                        			Depression is a psychiatric disorder whose main symptoms include low mood, loss of interest, anxiety, sleep disturbances, and changes in appetite. Orexin, a neuropeptide located in hypothalamic neurons, has a wide range of projections throughout the central nervous system and is involved in various behavioral modulations related to depression. This study systematically reviewed the effects of orexin and its receptor-related drugs on depression and found that orexin could exert complex regulatory effects on multiple brain regions by binding to related receptors, affecting emotions, sleep, anxiety, etc. The abnormal state of expression of plasma orexin in patients with depression was found. Exogenous orexin-A, selective orexin receptor 1 antagonists (SORA1s), selective orexin receptor 2 antagonists (SORA2s), and dual orexin receptor antagonists (DORAs) have demonstrated antidepressant-like effects in various animal models of depression. Among them, clinical trials involving exogenous orexin-A are relatively scarce. Drugs related to SORA1s and SORA2s, such as JNJ-61393215 and Setorexant, have made significant progress in the treatment of depression. DORAs, such as Suvorexant, Lemborexant, and Daridorexant, are primarily used to treat insomnia. Notably, Suvorexant has also shown potential in alleviating symptoms of anxiety and depression.
		                        		
		                        		
		                        		
		                        	
7.Strategies for the Syndrome Differentiation and Treatment of Malignant Tumors Based on the Theory of Stagnant Toxin
Luchang CAO ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Guanghui ZHU ; Jie LI
Journal of Traditional Chinese Medicine 2025;66(10):1000-1006
		                        		
		                        			
		                        			"Stagnation" is an important pathological state in the development and progression of malignant tumors. However, its intrinsic connection with different stages of tumor evolution has not been clearly elucidated in previous studies. Drawing on clinical practice, this paper proposes the theory of stagnant toxin, emphasizing stage-specific pathogenesis and differentiated treatment strategies for tumors based on the varying manifestations of stagnation at each phase. The theory interprets the pathogenesis of stagnant toxin across the stages of tumor development through the five elements "wood, fire, earth, metal, and water" corresponding respectively to wood stagnation in the precancerous stage, metal stagnation in the postoperative phase, fire stagnation during adjuvant therapy, earth stagnation in the progressive stage, and water stagnation in the advanced stage. Each type of stagnation reflects a distinct pathogenic mechanism, such as wood stagnation giving rise to disease, metal stagnation inducing residual symptoms, fire stagnation resulting in ulceration, earth stagnation spreading toxin transmission, and water stagnation leading to critical deterioration. Accordingly, the treatment principles include guiding wood stagnation with counterflow, dispersing metal stagnation to harmonize symptoms, venting fire stagnation to regress ulcers, depleting earth stagnation to block progression, and controlling water stagnation to preserve vitality. This theoretical framework offers a traditional Chinese medicine perspective for understanding and treating malignant tumors based on the concept of stagnant toxin. 
		                        		
		                        		
		                        		
		                        	
8.Practice innovation in pharmaceutical management for infusion safety in hospitalized patients
Jie CHEN ; Man YOU ; Pengfei CAO ; Wenfeng TAI ; Lu MENG ; Hong ZHANG ; Guanghong HE
China Pharmacy 2025;36(10):1238-1242
		                        		
		                        			
		                        			OBJECTIVE To establish a pharmaceutical management model for infusion safety in hospitalized inpatients and ensure the safety of drug use. METHODS Our hospital established the standardized management process for infusion scheme, formulated rules for compatibility contraindications in drug combinations. In the form of embedded hospital official account, the infusion scheme and medication guidance WeChat developed by pharmacists are pushed to the mobile phone of inpatients, providing electronic medication guidance services for patients, and forming a pharmaceutical management model for infusion safety of inpatients. RESULTS Our hospital provided a total of 45 291 inpatients with pharmaceutical services including the formulation of individualized infusion scheme and WeChat push infusion scheme and medication guidance as of December 2023. After the implementation of the management model, the intervention rate of pharmacists on the compatibility contraindications in drug combination of long-term medical orders for inpatients increased from 18.25% before implementation to 90.58% (P<0.01), and the satisfaction rate of inpatients increased from 87.50% to 94.50% (P<0.05). CONCLUSIONS The pharmaceutical management model for infusion safety of hospitalized patients integrates pharmaceutical services throughout the entire process of intravenous medication treatment. Pharmacists can participate in the management of infusion usage while providing qualified finished infusion products, achieving closed-loop management of pharmaceutical services, improving the hospital’s pharmaceutical service capabilities and patient satisfaction, and providing guarantees for the safety and effectiveness of patient medication.
		                        		
		                        		
		                        		
		                        	
9.Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
Yi DONG ; Juan CHENG ; Yun-Lin HUANG ; Yi-Jie QIU ; Jia-Ying CAO ; Xiu-Yun LU ; Wen-Ping WANG ; Kathleen MÖLLER ; Christoph F. DIETRICH
Ultrasonography 2025;44(3):232-242
		                        		
		                        			 Purpose:
		                        			This study aimed to evaluate the contrast-enhanced ultrasound with Sonazoid (Sonazoid-CEUS) features of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). 
		                        		
		                        			Methods:
		                        			In this retrospective study, patients who underwent surgical resection and were histopathologically diagnosed with NAFLD or cirrhosis-related HCC were included. All patients received Sonazoid-CEUS examinations within 1 week prior to hepatic surgery. The enhancement patterns of HCC lesions were evaluated and compared between the two groups according to the current World Federation for Ultrasound in Medicine and Biology guidelines. Multivariate logistic regression analysis was used to assess the correlations between Sonazoid-CEUS enhancement patterns and clinicopathologic characteristics. 
		                        		
		                        			Results:
		                        			From March 2022 to April 2023, a total of 151 patients with HCC were included, comprising 72 with NAFLD-related HCC and 79 with hepatitis B virus (HBV) cirrhosis–related HCC. On Sonazoid-CEUS, more than half of the NAFLD-related HCCs exhibited relatively early and mild washout within 60 seconds (54.2%, 39/72), whereas most HBV cirrhosis–related HCCs displayed washout between 60 and 120 seconds (46.8%, 37/79) or after 120 seconds (39.2%, 31/79) (P<0.001). In the patients with NAFLD-related HCC, multivariate analysis revealed that international normalized ratio (odds ratio [OR], 0.002; 95% confidence interval [CI], 0.000 to 0.899; P=0.046) and poor tumor differentiation (OR, 21.930; 95% CI, 1.960 to 245.319; P=0.012) were significantly associated with washout occurring within 60 seconds. 
		                        		
		                        			Conclusion
		                        			Characteristic Sonazoid-CEUS features are useful for diagnosing HCC in patients with NAFLD. 
		                        		
		                        		
		                        		
		                        	
10.Criteria and prognostic models for patients with hepatocellular carcinoma undergoing liver transplantation
Meng SHA ; Jun WANG ; Jie CAO ; Zhi-Hui ZOU ; Xiao-ye QU ; Zhi-feng XI ; Chuan SHEN ; Ying TONG ; Jian-jun ZHANG ; Seogsong JEONG ; Qiang XIA
Clinical and Molecular Hepatology 2025;31(Suppl):S285-S300
		                        		
		                        			
		                        			 Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC. 
		                        		
		                        		
		                        		
		                        	
            
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