1.Subxiphoid uniportal approach using double sternum retractors versus subxiphoid and subcostal arch three-portal approach of video-assisted thoracoscopic surgery thymectomy for thymoma treatment: A retrospective cohort study
Jinlan ZHAO ; Weiyang CHEN ; Lin LIN ; Lei WANG ; Jie LI ; Lin MA ; Longqi CHEN ; Hong CHEN ; Dong TIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(04):482-487
		                        		
		                        			
		                        			Objective To compare the efficacy and safety of video-assisted thoracoscopic surgery (VATS) thymectomy for the treatment of thymoma through subxiphoid uniportal approach using double sternum retractors, and subxiphoid and subcostal arch approach. Methods  We retrospectively analyzed the clinical data of the patients diagnosed with thymoma who underwent VATS thymectomy from June 2023 to June 2024 in West China Hospital. Patients were categorized based on the surgical approach into two groups: a subxiphoid uniportal VATS thymectomy (SUVT) group and a subxiphoid and subcostal arch VATS thymectomy (SASAT) group. Comparisons were made between the two groups regarding surgical duration, intraoperative blood loss, postoperative drainage, thymoma size and location, and postoperative pain assessed using the visual analogue scale (VAS). Results The SUVT group consisted of 20 patients, including 11 males and 9 females, with an average age of (51.5±14.3) years. The SASAT group comprised 40 patients, including 26 males and 14 females, with an average age of (50.0±13.0) years. Compared to the SASAT group, the SUVT group had significantly larger thymomas [ (5.9±2.7) cm vs. (4.2±2.1) cm, P=0.010] and a higher proportion of neoplasms located in the superior mediastinum (30.0% vs. 2.5%, P=0.007). Additionally, the VAS pain scores on postoperative days 3, 7, and 30 were significantly lower in the SUVT group compared to the SASAT group (P<0.05). There were no statistical differences between the two groups in demographic characteristics, operative time, intraoperative blood loss, duration and volume of postoperative drainage, length of postoperative hospital stay, or the VAS pain score on the first postoperative day. Conclusion  SUVT using double sternum retractors significantly reduces postoperative pain and provides superior efficacy in the resection of larger thymomas or those situated in the superior mediastinum.
		                        		
		                        		
		                        		
		                        	
2.Effect of Yinchenhao Tang Combined with Yinchen Zhufu Tang on Treg/Th17 Cells in Vitro from Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure
Menghui ZENG ; Shan DU ; Nianhua TAN ; Jie PENG ; Bin CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):43-51
		                        		
		                        			
		                        			ObjectiveTo study the regulatory effects of Yinchenhao Tang combined with Yinchen Zhufu Tang on the expression of regulatory T (Treg)/helper T 17 (Th17) cells cultured in vitro from the patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). MethodsFresh peripheral blood was collected from the patients with HBV-ACLF for the separation of peripheral blood mononuclear cells (PBMCs). Immunomagnetic beads were used to isolate primary Treg and naive CD4+ T cells. After in vitro expansion, naive CD4+ T cells were induced to differentiate into Th17 cells. Rats were treated with the clearing method (Yinchenhao Tang), warming method (Yinchen Zhufu Tang), and combination of clearing method with warming method (Yinchenhao Tang combined with Yinchen Zhufu Tang, also known as Wenyang Jiedu Huayu Prescription), respectively, and then the medicated plasma samples were collected. Meanwhile, blank plasma was collected from the rats treated with normal saline. Cells were classified into blank, clearing method (5.04 g·kg-1), warming method (6.21 g·kg-1), and combination of clearing method with warming method (17.1 g·kg-1) groups and treated with corresponding plasma. The frequency of Treg/Th17 cells was detected by flow cytometry. The level of transforming growth factor-β (TGF-β) was measured by the enzyme-linked immunosorbent assay. The cytometric bead array (CBA) was employed to measure the levels of interleukin-10 (IL-10), interleukin-17A (IL-17A), tumor necrosis factor-α (TNF-α), and interleukin-23 (IL-23). The mRNA and protein levels of Forkhead box P3 (FoxP3) and retinoic acid-related orphan receptor-gamma t (ROR-γt) were determined by Real-time PCR and Western blot, respectively. ResultsCompared with the blank group, the combination of clearing method with warming method group showed decreased frequency of Treg and Th17 cells, lowered levels of Treg cytokines (TGF-β and IL-10) and Th17 cytokines (TNF-α, IL-17A, and IL-23), and down-regulated mRNA and protein levels of FoxP3 and ROR-γt (P<0.01). Compared with the clearing method group, the combination of clearing method with warming method group showed decreased Treg cell frequency and down-regulated mRNA and protein levels of FoxP3. Meanwhile, the combination group showed decreased Th17 cell frequency, lowered levels of TGF-β, IL-10, TNF-α, IL-17A, and IL-23, and down-regulated mRNA and protein levels of ROR-γt (P<0.05, P<0.01). Compared with the warming method group, the combination of clearing method with warming method group showed decreased frequency of Treg cells and down-regulated mRNA and protein levels of FoxP3. Meanwhile, the combination group showed decreased Th17 cell frequency, declined levels of TGF-β, IL-10, TNF-α, IL-17A, and IL-23, and down-regulated mRNA and protein levels of ROR-γt (P<0.05). ConclusionThe combination of clearing method with warming method can down-regulate the expression of specific cytokines of Treg and Th17 cells, inhibit the over activation of Treg and Th17 cells, and reduce the secretion of cytokines such as TGF-β, IL-10, TNF-α, IL-17A, and IL-23, thereby alleviating inflammation and improving the prognosis of the patients with liver failure. 
		                        		
		                        		
		                        		
		                        	
3.Differences in Expression of Intestinal Flora in Patients with Different TCM Syndrome Types of "Yang Huang-Yin-Yang Huang-Yin Huang" in Hepatitis B Virus-related Acute-on-chronic Liver Failure
Shan DU ; Menghui ZENG ; Nianhua TAN ; Jie PENG ; Bin CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):62-69
		                        		
		                        			
		                        			ObjectiveTo investigate the differential expression of intestinal flora in patients with different traditional Chinese medicine (TCM) syndrome types (Yang Huang syndrome, Yin-Yang Huang syndrome, and Yin Huang syndrome) of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) and clarify the biological basis of jaundice and Yin Huang syndrome in liver failure. MethodsA total of 20 cases of HBV-ACLF patients were included in the Yang Huang group, 20 cases in the Yin-Yang Huang group, 16 cases in the Yin Huang group, and 20 healthy adult volunteers. 16S rRNA gene sequencing was used to detect the diversity, species distribution, and differences of the subjects' intestinal flora, and bioinformatics analysis was conducted. ResultsCompared with those in the healthy control group, the species richness and diversity of intestinal flora in the HBV-ACLF Yang Huang group, Yin-Yang Huang group, and Yin Huang group were significantly reduced, and there were significant differences in the composition of intestinal flora compared with healthy volunteers. However, there were no significant differences in the species richness, diversity, and composition of intestinal flora among the three groups. LEfSe analysis showed that compared with the healthy control group, the HBV-ACLF Yang Huang group showed significant enrichment of Staphylococcus aureus(P<0.01). Yin-Yang Huang group showed significant enrichment of s_Ileibacterium valens(P<0.05,P<0.01), and the Yin Huang group showed significant enrichment of Enterococcus faecium and Streptococcus sali varius(P<0.05). These strains may be biomarkers between the three groups of patients and the healthy control group. Compared with that in the Yin-Yang Huang group, Tyzzerella_nexilis was significantly enriched in the Yang-Huang group, and Streptococcus lactiae was significantly enriched in the Yin-Yang Huang group. Compared with that in the Yang-Huang group and the Yin-Yang Huang group, Enterococcus faecalis was significantly enriched in the Yin Huang group. The above strains may be biomarkers among the three groups of patients, and Enterococcus faecium may be a biomarker for the transition from the Yang Huang group to the Yin Huang group. ConclusionsThere are significant differences in the intestinal flora between patients with HBV-ACLF Yang Huang syndrome, Yin-Yang Huang syndrome, and Yin Huang syndrome. Enterococcus faecium is significantly enriched in the Yin Huang syndrome group, suggesting that dysbiosis of the intestinal flora may be the biological basis for jaundice and Yin Huang syndrome in liver failure. 
		                        		
		                        		
		                        		
		                        	
4.Changes of Treg/Th17 Cell Expression in Peripheral Blood of Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure in Five Types of Traditional Chinese Medicine Syndrome
Shan DU ; Menghui ZENG ; Nianhua TAN ; Jie PENG ; Bin CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):70-76
		                        		
		                        			
		                        			ObjectiveTo study the expression differences of regulatory T cells (Treg) and T helper 17 cells (Th17) in the peripheral blood of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) in five types of traditional Chinese medicine (TCM) syndrome. MethodsA total of 144 patients with HBV-ACLF were included and divided into five types of TCM syndrome, including 34 cases of heat-toxin amassment syndrome, 44 cases of dampness-heat amassment syndrome, 27 cases of Qi-deficiency and stasis jaundice syndrome, 21 cases of spleen-kidney Yang deficiency syndrome, and 18 cases of liver-kidney Yin deficiency syndrome. Meanwhile, 30 healthy volunteers were included as controls. The frequency of Treg and Th17 cells in the peripheral blood of subjects in each group was detected by flow cytometry, and the Treg/Th17 ratio was calculated. Cytometric bead array (CBA) was used to detect the levels of cytokines interleukin (IL)-10, transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α), IL-17A, and IL-23. Real-time fluorescence quantitative PCR (Real-time PCR) detected the mRNA expression of forkhead box P3 (FoxP3) and retinoic acid-related orphan receptor gamma t (ROR-γt). Results(1) Compared with that in the healthy control group, the frequency of Treg and Th17 cells in patients with various TCM syndrome types of HBV-ACLF increased (P<0.05). Compared with that in the heat-toxin amassment syndrome group, the frequency of Treg and Th17 cells decreased in the dampness-heat amassment syndrome group (P<0.05), while the frequency of Treg and Th17 cells increased in the Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with that in the dampness-heat amassment syndrome group, the frequency of Treg and Th17 cells increased in the dampness-heat amassment syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with that in the Qi-deficiency and stasis jaundice syndrome group, the frequency of Treg and Th17 cells increased in the spleen-kidney Yang deficiency syndrome group (P<0.05), while the frequency of Treg and Th17 cells decreased in the liver-kidney Yin deficiency syndrome group (P<0.05). Compared with the spleen-kidney Yang deficiency syndrome group, the frequency of Treg and Th17 cells decreased in the liver-kidney Yin deficiency syndrome group (P<0.05). (2) Compared with that in the healthy control group, the Treg/Th17 cell ratio in patients with various TCM syndromes of HBV-ACLF decreased (P<0.05). Compared with that in the heat-toxin amassment syndrome group, the Treg/Th17 cell ratio increased in the dampness-heat amassment syndrome group (P<0.05), while it decreased in the Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with that in the dampness-heat amassment syndrome group, the Treg/Th17 cell ratio decreased in the Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with that in the Qi-deficiency and stasis jaundice syndrome group, the Treg/Th17 cell ratio increased in the spleen-kidney Yang deficiency syndrome group and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with the spleen-kidney Yang deficiency syndrome group, the Treg/Th17 cell ratio in the liver-kidney Yin deficiency syndrome group increased (P<0.05). (3) Compared with those in the healthy control group, the levels of Treg-related cytokines IL-10 and TGF-β, as well as Th17-related cytokines TNF-α, IL-17A, and IL-23, were elevated in patients with various TCM syndrome types of HBV-ACLF (P<0.05). There was no significant difference in TNF-α levels among different TCM syndrome types. Compared with those in the heat-toxin amassment syndrome group, the levels of IL-10, TNF-β, IL-17A, and IL-23 in the dampness-heat amassment syndrome group, Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome groups increased (P<0.05). Compared with those in the dampness-heat amassment syndrome group, the levels of IL-10, TGF-β, IL-17A, and IL-23 increased in the Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with those in the Qi-deficiency and stasis jaundice syndrome group, the levels of IL-10, TGF-β, IL-17A, and IL-23 in the spleen-kidney Yang deficiency syndrome group increased (P<0.05), while those in the liver-kidney Yin deficiency syndrome group decreased (P<0.05). Compared with those in the spleen-kidney Yang deficiency syndrome, the levels of IL-10, TGF-β, IL-17A, and IL-23 in the liver-kidney Yin deficiency syndrome group decreased (P<0.05). (4) Compared with that in the healthy control group, the mRNA of Treg/Th17 cell specific transcription factors FoxP3 and ROR-γt were elevated in patients with various TCM syndrome types of HBV-ACLF (P<0.05). Compared with that in the heat-toxin amassment syndrome group, the mRNA of FoxP3 and ROR-γt increased in the Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome group (P<0.05). Compared with that in the dampness-heat amassment syndrome group, the mRNA of FoxP3 and ROR-γt increased in the Qi-deficiency and stasis jaundice syndrome group, spleen-kidney Yang deficiency syndrome group, and liver-kidney Yin deficiency syndrome (P<0.05). Compared with that in the Qi-deficiency and stasis jaundice syndrome group, the mRNA of FoxP3 and ROR-γt in the spleen-kidney Yang deficiency syndrome group increased (P<0.05), and it decreased in the liver-kidney Yin deficiency syndrome group (P<0.05). Compared with that in the spleen-kidney Yang deficiency syndrome group, the mRNA of FoxP3 and ROR-γt decreased in the liver-kidney Yin deficiency syndrome group (P<0.05). ConclusionThe frequency and ratio of Treg/Th17 cells, as well as the expression of related cytokines and specific receptors in peripheral blood of patients with HBV-ACLF in five types of TCM syndromes are different, which has certain reference value for TCM syndrome differentiation and treatment of patients with HBV-ACLF. 
		                        		
		                        		
		                        		
		                        	
5.A cohort study of triglyceride-glucose index and risk of stroke in middle-aged and elderly individuals with hypertension
Hongyan CHEN ; Kui FANG ; Jie ZHANG
Shanghai Journal of Preventive Medicine 2025;37(5):436-440
		                        		
		                        			
		                        			ObjectiveTo investigate the association between triglyceride-glucose (TyG) index and the risk of stroke in middle-aged and elderly individuals with hypertension, so as to provide more evidence for the prevention and treatment of stroke. MethodsMiddle-aged and elderly hypertensive individuals who took part in all four surveys in 2011, 2013, 2015, and 2018 were selected as the research subjects based on data from the China Health and Retirement Longitudinal Study (CHARLS). Participants were divided into four groups (≤Q1, >Q1~Q2, >Q2~Q3, and >Q3) based on TyG index quartiles, and the cumulative risk of stroke in different groups was analyzed using the Kaplan-Meier method. Different Cox proportional hazards regression models were constructed to analyze the relationship between the TyG index and stroke risk. Sensitivity analysis were performed to evaluate the robustness of the results. ResultsA total of 4 596 participants were included in the study. Among them, 338 individuals (7.35%) had a stroke during the 7-year follow-up period. The cumulative risk of stroke increased with higher TyG index levels. Results from the Cox regression models indicated that higher TyG levels were associated with an increased risk of stroke among middle-aged and elderly individuals with hypertension. Compared with the lowest TyG index quartile (≤Q1: TyG index ≤8.33) group, the highest quartile (>Q3: TyG index >9.17) group showed a 45.10% increased risk of stroke (HR=1.451, 95% CI:1.017‒2.072). ConclusionA higher TyG index is associated with an increased risk of stroke in middle-aged and elderly individuals with hypertension. 
		                        		
		                        		
		                        		
		                        	
6.Detection and clinical analysis of drug-induced antibodies related to β-lactam antibiotics
Yangyang ZHENG ; Rongpeng WANG ; Jie ZHAO ; Bingzheng ZHUO ; Feng CHEN
Chinese Journal of Blood Transfusion 2025;38(7):922-927
		                        		
		                        			
		                        			Objective: To investigate the positive rate of drug-induced antibodies produced by the clinical application of β-lactam antibiotics, and analyze the differences in the detection methods and related influencing factors. Methods: A total of 350 adult inpatients who developed anemia after using β-lactam antibiotics for 3 days or more in Inner Mongolia People's hospital were selected as the experimental group, and 240 adult inpatients treated with β-lactam antibiotics for 3 days or more who did not develop anemia as the control group. The drug-induced antibody tests, direct antiglobulin tests, and unexpected antibody screening were performed on both groups, and the influencing factors of drug-induced antibodies were analyzed. Results: The numbers of positive cases of drug-induced antibody detected by the drug-coated red blood cell method in the experimental group and the control group were 12(12/350, 3.43%) and 2(2/240, 0.83%) respectively, with statistically significant differences (P<0.05). No drug-induced antibodies were detected in either group using the drug addition method. In the experimental group, the red blood cell method detected β-lactam drug-induced antibodies in 12 cases (12/350, 3.43%), while the drug added method detected 0 cases (0/350, 0.00%), with statistically significant differences (P<0.05). In the control group, the detection rates of two methods showed no statistically significant difference (P>0.05). In the experimental group, 7 cases of β-lactam antibodies were detected in the cephalosporin group (7/293, 2.40%) and 5 cases in the non-cephalosporin group (5/58, 8.62%), with statistically significant differences (P<0.05). There was no statistically significant difference between the second-generation and third-generation cephalosporin drugs (P>0.05). When the experimental group was stratified according to the history of blood transfusion and the blood type of patients, no statistically significant differences were observed between subgroups (P>0.05). Conclusion: Anemia may be related to the production of drug-induced antibodies followingβ-lactam antibiotics treatment. Therefore, improving the clinical awareness of drug-induced antibodies to β-lactam antibiotics is of great significance to clarify the causes of anemia and reduce unnecessary blood transfusions.
		                        		
		                        		
		                        		
		                        	
7.Effects of Xiaozhong Zhitong Mixture (消肿止痛合剂) on Angiogenesis and the Dll4/Notch1 Signaling Pathway in Wound Tissue of Diabetic Foot Ulcer Model Rats
Xiao HAN ; Tao LIU ; Yuan SONG ; Jie CHEN ; Jiaxuan SHEN ; Jing QIAO ; Hengjie WANG ; Lewen WU ; Yazhou ZHAO
Journal of Traditional Chinese Medicine 2025;66(16):1695-1703
		                        		
		                        			
		                        			ObjectiveTo investigate the potential machanism of Xiaozhong Zhitong Mixture (消肿止痛合剂, XZM) in the treatment of diabetes foot ulcer (DFU). MethodsFifty SD rats were randomly divided into blank group, model group, XZM group, inhibitor group, XZM plus inhibitor group (combination group), with 10 rats in each group. Except for the blank group, rats were fed with high-sugar, high-fat, high-cholesterol diet, intraperitoneally injected with streptozotocin, and subjected to skin defect to establish DFU model. After successful modeling, the XZM group and the combination group were given 1 ml/(100 g·d)of XZM by gavage, while the blank group, model group, and inhibitor group were all given an equal volume of 0.9% sodium chloride injection by gavage. Thirty minutes later, the inhibitor group and the combination group were intraperitoneally injected with 5 mg/(kg·d) of Notch1 inhibitor DAPT. All groups were treated once a day. After 14 days of administration, the skin tissue from the dorsal foot of the blank group rats and wound tissue from the other groups were collected. The pathological changes of granulation tissue in the wound were detected using hematoxylin eosin (HE) staining. The microvascular density (MVD) in wounds was detected through immunohistochemical staining. Real time fluorescence quantitative polymerase chain reaction (RT-PCR) and western blotting were used to detect the mRNA and protein levels of Notch1 homolog (Notch1), Delta-like ligand 4 (Dll4), Delta-like ligand 4 (VEGF), and angiopoietin 2 (Ang-2), respectively. ResultsHistological results showed that the epidermal structure in the dorsal foot skin tissue of the rats in the blank group was intact. In the wound tissue of the model group, the epidermis exhibited excessive keratinization, vacuolar cytoplasm, and a large number of inflammatory cells infiltrating the tissue, while in the XZM group, a large amount of scab formation was observed in the epidermis, with no significant inflammatory cell infiltration and a noticeable increase in fibroblasts. In the combination group and the inhibitor group, partial epidermal scab formation was observed in the wound tissue with a small amount of inflammatory cell infiltration. Compared to those in the blank group, the MVD in the wound tissue increased in the model group, as well as the mRNA expression and protein levels of Notch1 and Dll4, while VEGFA and Ang-2 mRNA expression and protein levels significantly decreased (P<0.05 or P<0.01). Compared to those in the model group, the MVD in the wound tissue of all medication groups significantly increased, and the mRNA and protein levels of Notch1 and Dll4 decreased, while VEGFA and Ang-2 mRNA expression and protein levels increased (P<0.05 or P<0.01). Compared to the XZM group, the inhibitor group and the combination group showed decreased MVD in wound tissue, increased Notch1 and Dll4 mRNA and protein levels, and decreased expression of VEGFA and Ang-2 mRNA and proteins (P<0.05 or P<0.01). ConclusionXZM can effectively promote wound healing in DFU rats, and its mechanism of action may be related to the inhibition of Dll4/Notch1 signaling pathway in the wound tissue, therey promoting angiogenesis. 
		                        		
		                        		
		                        		
		                        	
8.Detection and clinical analysis of drug-induced antibodies related to β-lactam antibiotics
Yangyang ZHENG ; Rongpeng WANG ; Jie ZHAO ; Bingzheng ZHUO ; Feng CHEN
Chinese Journal of Blood Transfusion 2025;38(7):922-927
		                        		
		                        			
		                        			Objective: To investigate the positive rate of drug-induced antibodies produced by the clinical application of β-lactam antibiotics, and analyze the differences in the detection methods and related influencing factors. Methods: A total of 350 adult inpatients who developed anemia after using β-lactam antibiotics for 3 days or more in Inner Mongolia People's hospital were selected as the experimental group, and 240 adult inpatients treated with β-lactam antibiotics for 3 days or more who did not develop anemia as the control group. The drug-induced antibody tests, direct antiglobulin tests, and unexpected antibody screening were performed on both groups, and the influencing factors of drug-induced antibodies were analyzed. Results: The numbers of positive cases of drug-induced antibody detected by the drug-coated red blood cell method in the experimental group and the control group were 12(12/350, 3.43%) and 2(2/240, 0.83%) respectively, with statistically significant differences (P<0.05). No drug-induced antibodies were detected in either group using the drug addition method. In the experimental group, the red blood cell method detected β-lactam drug-induced antibodies in 12 cases (12/350, 3.43%), while the drug added method detected 0 cases (0/350, 0.00%), with statistically significant differences (P<0.05). In the control group, the detection rates of two methods showed no statistically significant difference (P>0.05). In the experimental group, 7 cases of β-lactam antibodies were detected in the cephalosporin group (7/293, 2.40%) and 5 cases in the non-cephalosporin group (5/58, 8.62%), with statistically significant differences (P<0.05). There was no statistically significant difference between the second-generation and third-generation cephalosporin drugs (P>0.05). When the experimental group was stratified according to the history of blood transfusion and the blood type of patients, no statistically significant differences were observed between subgroups (P>0.05). Conclusion: Anemia may be related to the production of drug-induced antibodies followingβ-lactam antibiotics treatment. Therefore, improving the clinical awareness of drug-induced antibodies to β-lactam antibiotics is of great significance to clarify the causes of anemia and reduce unnecessary blood transfusions.
		                        		
		                        		
		                        		
		                        	
9.A 30-year review and outlook on esophageal acid and pressure measurement
Yong JIANG ; Wentao FANG ; Zhigang LI ; Wenhu CHEN ; Wenhu PAN ; Yanfang ZHENG ; Hong ZHANG ; Yuchen SU ; Jie ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(06):766-770
		                        		
		                        			
		                        			The Department of Thoracic Surgery of Shanghai Chest Hospital has performed esophageal function testing for over 30 years, being the only department of its kind in China with this capability. The pressure testing and 24-hour pH/impedance monitoring of the esophagus is of great help to assist in the diagnosis and treatment of benign and malignant esophageal diseases related to it. Thanks to the esophageal function test, in addition to the routine various endoscopic anti-reflux procedures, our hospital has taken the lead in China in recent years to carry out a series of clinical and research work for benign esophageal diseases, such as the development of magnetic ring, double nedoscopic combination and new anti-reflux endoscopic techniques. In recent years, we have carried out high-resolution esophageal manometry and 24-hour pH/impedance monitoring for patients with interstitial pneumonia and pulmonary fibrosis suspected to be caused by gastroesophageal acid reflux. We can better assess the correlation between gastroesophageal reflux and pulmonary fibrosis, and to provide the different clinical treatments and even surgical interventions. The Bravo capsule is used more often in the United States, and it has obvious advantages over traditional approach for acid measurement. We strongly call for the collaboration between industry and academic institutions in this field, and the development of our own related products with independent intellectual property rights.
		                        		
		                        		
		                        		
		                        	
10.Improvement effect and mechanism of Shengmai powder on heart failure mice with qi-yin deficiency
Lanfang KANG ; Jian LI ; Yating ZHAO ; Yingchun CHEN ; Guiyin CHEN ; Xiaobo NIE ; Jiao LIU ; Jie CHENG
China Pharmacy 2025;36(17):2127-2133
		                        		
		                        			
		                        			OBJECTIVE To study the improvement effect and mechanism of Shengmai powder on heart failure (HF) mice with qi-yin deficiency. METHODS The mice were randomly divided into blank group (water), model group (water), Shengmai powder low-, medium-, and high-dose groups [2.61, 5.22 and 10.44 g/kg (based on crude drug dosage)] and positive control group (metoprolol, 30 mg/kg), with 10 mice in each group. Except for the blank group, all other groups were subcutaneously injected with D-galactose, and a qi-yin deficiency HF mice model was established by continuous food restriction and weight-bearing swimming. At the same time of modeling, the corresponding medicine/water was gavaged once a day for five weeks. The general state of mice was recorded and the traditional Chinese medicine (TCM) syndrome score was evaluated. Behavioral experiments were conducted to investigate the total distance of open field action, the percentage of immobility time, and the swimming exhaustion time of mice. The contents of aspartate transaminase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH) in the serum of mice were detected; cardiac function indexes [heart rate, left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular mass index and whole heart mass index] were all detected; the histopathological morphology of mice myocardium was observed; the level of cardiomyocyte apoptosis in mice was detected; mRNA expression levels of B-cell lymphoma 2 (Bcl-2), Bcl-2 associated X protein (Bax), and Cleaved-caspase-3 in myocardial tissue of mice were detected; the phosphorylation levels of sarcoplasmic reticulum calcium regulatory related proteins [ryanodine receptor 2 (RyR2) and phospholamban (PLB)] in myocardial tissue of mice were detected. RESULTS Compared with the blank group, the body weight, total distance of open field action, swimming exhaustion time, LVEF, LVEDD, Bcl-2 mRNA expression level in myocardial tissue and PLB protein phosphorylation level in the model group were significantly reduced/shortened (P<0.05); TCM syndrome score, the percentage of immobility time, heart rate, LVESD, left ventricular mass index, whole heart mass index, cardiomyocyte apoptosis rate, the contents of CK, LDH and AST in serum, mRNA expression levels of Cleaved-caspase-3 and Bax and the phosphorylation level of RyR2 protein in myocardial tissue were significantly increased (P<0.05); there were inflammatory cell infiltration, disordered cell arrangement and obvious myocardial interstitial fibrosis in myocardial tissue. After the intervention of Shengmai powder, most of the above quantitative indexes in mice were significantly reversed (P<0.05), the inflammatory cell infiltration in myocardial tissue was reduced, and the degree of fibrosis was significantly reduced. CONCLUSIONS Shengmai powder can improve cardiac function, reduce the level of cardiomyocyte apoptosis and myocardial fibrosis in HF mice with qi-yin deficiency. Its mechanism may be related to the regulation of the expression of sarcoplasmic reticulum calcium regulation related proteins.
		                        		
		                        		
		                        		
		                        	
            
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