1.Principles, technical specifications, and clinical application of lung watershed topography map 2.0: A thoracic surgery expert consensus (2024 version)
Wenzhao ZHONG ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Wei JIANG ; Deping ZHAO ; Hecheng LI ; Xiaolong YAN ; Lijie TAN ; Junqiang FAN ; Guibin QIAO ; Qiang NIE ; Mingqiang KANG ; Weibing WU ; Hao ZHANG ; Zhigang LI ; Zihao CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):141-152
With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.
2.Clinical Observation of Guben Quyu Jiedu Prescription in Treating Nocturnal Hypoxemia of COPD Combined with OSAHS
Yi HE ; Ziyu LI ; Wenjiang ZHANG ; Jinzhu GAO ; Changzheng FAN ; Beibei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):146-153
ObjectiveTo observe the clinical efficacy and safety of Guben Quyu Jiedu prescription in treating nocturnal hypoxemia of chronic obstructive pulmonary disease (COPD) combined with Obstructive sleep apnea hypopnea syndrome ( OSAHS ) (deficiency of lung, spleen and kidney with blood stasis and toxicity). MethodsThe paper used a forward-looking, random double-blind, placebo-controlled design method to select 96 patients with COPD combined with OSAHS, and their traditional Chinese medicines (TCM) syndrome differentiation was deficiency of lung, spleen and kidney with blood stasis and toxicity. These patients were randomly divided into the observation group and the control group, with 48 cases in each group. Based on conventional Western medicine treatment, the observation group was treated with Guben Quyu Jiedu prescription and the control group was treated with traditional Chinese medicine placebo. Both courses of treatment were 90 days. Then the paper compared the changes in minimum pulse oxygen saturation (SpO2) during the night, apnea index (AHI), OSAHS efficacy evaluation, TCM syndrome efficacy evaluation, and TCM symptom score before and after treatment between the two groups. ResultsThere were 5 withdrawals in the observation group and 8 withdrawals in the control group, so 43 cases in the observation group and 40 cases in the control group completed the trial. Compared with the condition before treatment, the minimum SpO2 during the night and AHI in the observation group were significantly improved at night (P<0.01) and were better than those in the control group (P<0.01). OSAHS efficacy in the observation group was better than in the control group (χ2=7.085, P<0.05). In terms of TCM syndrome efficacy, the total effective rate was 81.40% (35/43) in the observation group, significantly higher than that in the control group, which was 15.00% (6/40) (χ2=36.78, P<0.01). The TCM symptom scores of the two groups were improved compared with the condition before treatment, and the effect of the two groups was similar in the four main symptoms of snoring, choking, lethargy, and cough. However, the observation group was better than the control group in 10 details such as dizziness, headache, chest tightness, chest pain, wheezing, dry mouth, and thirst (P<0.05). ConclusionUsing Guben Quyu Jiedu prescription combined with conventional Western medicine can treat COPD combined with OSAHS hypoxemia at night (deficiency of lung, spleen and kidney with blood stasis and toxicity). In this way, the minimum pulse oxygen saturation (SpO2) of patients, the level of disease control, and the quality of life of patients can be improved, and the clinical symptoms can be relieved.
3.Analysis of Dynamic Change Patterns of Color and Composition During Fermentation of Myristicae Semen Koji
Zhenxing WANG ; Mengmeng FAN ; Le NIU ; Suqin CAO ; Hongwei LI ; Zhenling ZHANG ; Hanwei LI ; Jianguang ZHU ; Kai LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):222-229
ObjectiveTo explore the changes in volatile components, total polysaccharides, enzyme activity, and chromaticity value of Myristicae Semen Koji(MSK) during the fermentation process, and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry(GC-MS), the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method, dinitrosalicylic acid method(DNS), and carboxymethyl cellulose sodium salt method(CMC-Na) were used to investigate the total polysaccharide content, amylase activity, and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values, revealing the fermentation process of MSK and the dynamic changes of various measurement indicators, partial least squares-discriminant analysis(PLS-DA) was used to explore the differential compounds of MSK at different fermentation degrees, and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides, enzyme activity, and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK, the relative contents of components such as (+)-α-pinene, β-phellandrene, β-pinene, (+)-limonene, and p-cymene obviously increased, while the relative contents of components such as safrole, methyl isoeugenol, methyleugenol, myristicin, and elemicin significantly decreased. During the fermentation process, the total polysaccharide content showed an upward trend, while the activities of amylase and cellulase showed an initial increase followed by a decrease, and reached their maximum value at 40 h. the overall brightness(L*) and total color difference(ΔE*) gradually increased, while the changes in red-green value(a*) and yellow-blue value(b*) were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times, and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene, β-phellandrene, methyleugenol, β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation, the volatile components, total polysaccharides, amylase activity, and cellulase activity of MSK undergo significant changes, and there is a clear correlation between them and chromaticity values, which reveals the dynamic changes in the fermentation process and related indicators of MSK, laying a foundation for the quality control.
4.Treatment of IgA Nephropathy by Tonifying Kidney and Invigorating Spleen as Well as Detoxifying and Relieving Sore-throat Based on PIgR-CR1-mediated Mucosal-renal Axis
Fan LI ; Hongan WANG ; He NAN ; Mingyu HE ; Chengji CUI ; Yinping WANG ; Yutong LIU ; Shoulin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):237-244
Immunoglobulin A nephropathy (IgAN) is the primary glomerulonephritis with the highest incidence rate in the world. It is also the main cause of end-stage renal disease (ESRD) in China, which has brought heavy economic burden to the society and patient families. Traditional Chinese medicine (TCM) has certain advantages in treating IgAN. In TCM, IgAN is classified into consumptive disease, hematuria, and edema categories, with the location in the kidney and involving the lung, liver, and spleen. Professor Ren Jixue, a master of TCM, believes that kidney deficiency and spleen deficiency are the root causes of IgAN, and the throat is the source of the disease. He proposed the theory of throat-kidney correlation and used the method of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat to treat IgAN, achieving significant therapeutic effects. Studies have shown that IgAN is closely related to mucosal immune defense. IgAN patients often experience recurrent and gradually worsening symptoms due to mucosal infections, and polymeric Ig receptor (PIgR) is an important component of mucosal defense function. The lack of PIgR leads to the accumulation of IgA molecules in the mucosal lamina propria, and the molecules enter the bloodstream in large quantities and ultimately deposit in the kidneys, causing kidney damage. Complement regulatory protein complement receptor type 1 (CR1) exists on red blood cells and glomeruli and has the function of inhibiting the activation and differentiation of B cells, clearing immune complexes, and inhibiting excessive activation of the complement system. Therefore, regulating the immune defense function through the mucosal-renal axis mediated by PIgR-CR1 will be an important target for preventing and treating IgAN. Based on the theory of throat-kidney correlation, this article explores the effects and molecular mechanisms of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat in preventing and treating IgAN by regulating the mucosal-kidney axis mediated by PIgR-CR1. It provides effective theoretical support and a scientific basis for TCM prevention and treatment of IgAN based on the theory of throat-kidney correlation.
5.Treatment of IgA Nephropathy by Tonifying Kidney and Invigorating Spleen as Well as Detoxifying and Relieving Sore-throat Based on PIgR-CR1-mediated Mucosal-renal Axis
Fan LI ; Hongan WANG ; He NAN ; Mingyu HE ; Chengji CUI ; Yinping WANG ; Yutong LIU ; Shoulin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):237-244
Immunoglobulin A nephropathy (IgAN) is the primary glomerulonephritis with the highest incidence rate in the world. It is also the main cause of end-stage renal disease (ESRD) in China, which has brought heavy economic burden to the society and patient families. Traditional Chinese medicine (TCM) has certain advantages in treating IgAN. In TCM, IgAN is classified into consumptive disease, hematuria, and edema categories, with the location in the kidney and involving the lung, liver, and spleen. Professor Ren Jixue, a master of TCM, believes that kidney deficiency and spleen deficiency are the root causes of IgAN, and the throat is the source of the disease. He proposed the theory of throat-kidney correlation and used the method of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat to treat IgAN, achieving significant therapeutic effects. Studies have shown that IgAN is closely related to mucosal immune defense. IgAN patients often experience recurrent and gradually worsening symptoms due to mucosal infections, and polymeric Ig receptor (PIgR) is an important component of mucosal defense function. The lack of PIgR leads to the accumulation of IgA molecules in the mucosal lamina propria, and the molecules enter the bloodstream in large quantities and ultimately deposit in the kidneys, causing kidney damage. Complement regulatory protein complement receptor type 1 (CR1) exists on red blood cells and glomeruli and has the function of inhibiting the activation and differentiation of B cells, clearing immune complexes, and inhibiting excessive activation of the complement system. Therefore, regulating the immune defense function through the mucosal-renal axis mediated by PIgR-CR1 will be an important target for preventing and treating IgAN. Based on the theory of throat-kidney correlation, this article explores the effects and molecular mechanisms of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat in preventing and treating IgAN by regulating the mucosal-kidney axis mediated by PIgR-CR1. It provides effective theoretical support and a scientific basis for TCM prevention and treatment of IgAN based on the theory of throat-kidney correlation.
6.Extraction and identification of primary rat brain microvascular endothelial cells by improved tissue block culture method
Fan Zhang ; Bolin Li ; Ming Chi ; Haiqin Liu ; Yuanyu Tang
Acta Universitatis Medicinalis Anhui 2025;60(1):10-14
Objective :
To investigate the brain microvascular tissue block culture method for extracting primary rat brain microvascular endothelial cells and identify its effect.
Methods :
Brain tissue from 4-week-old Sprague Dawley rats was screened, pre-digested and solidified to obtain brain microvascular segments. These segments were subsequently placed in a CO2incubator for primary culture. The target cells were identified by cell morphology and immunocytochemical staining for factor Ⅷ-related antigen.
Results :
After a 48-hour culture periodin vitro, the short spindle cells crawled out from around the brain microvascular segments. After 72 hours, island-like cell culsters formed. After 96 hours the clusters fused and the cells formed a typical monolayer, cobble stone-like, and mosaic arrangement. Factor Ⅷ-related antigen immunocytochemical staining showed that the cytoplasm of the cells appeared brown-red, indicating positive expression; DAB stained the nucleus, showing blue-dark.
Conclusion
The brain microvascular tissue block culture method can isolate and culture primary rat brain microvascular endothelial cells.
7.Treatment Approach for Diabetes with Coronary Heart Disease Based on the Heart-Spleen-Kidney Triad Holistic Perspective
Xitong SUN ; Xinbiao FAN ; Huan ZHOU ; Xiaofei GENG ; Aolin LI ; Wenyu SHANG ; Junping ZHANG
Journal of Traditional Chinese Medicine 2025;66(7):750-754
It is believed that diabetes complicated with coronary heart disease is closely related to the functional interplay of the heart, spleen, and kidneys. This paper proposed the concept of the heart-spleen-kidney as a unified system for understanding and treating the disease. At the early stage, spleen and kidney deficiency leads to the internal accumulation of phlegm, dampness, and turbid lipids, causing impaired blood circulation and vascular obstruction, so treatment should focus on tonify the kidneys and strengthening the spleen, activating blood circulation and resolving stasis, using the self-prescribed Tangxin Maiwen Formula (糖心脉温方). As the disease progresses, further decline of spleen and kidney function results in inadequate nourishment of the heart, leading to blood stasis and the accumulation of phlegm, dampness, and turbid lipids, which may transform into pathogenic heat and toxins, causing heart damage, then treatment should emphasize on boosting qi and nourishing yin, clearing heat, activating blood and resolving toxins, using the self-prescribed Tangxin Maiqing Formula (糖心脉清方). In advanced stages, three zang organs, the heart, spleen, and kidneys, become severely impaired, leading to mental activity fail to be nourished and abnormal cognitive functions, so treatment should focus on harmonizing the three zang organs simultaneously, using the self-prescribed Yunpi Tiaoxin Decoction (运脾调心汤). This approach aims to provide a clinical framework for the diagnosis and treatment of diabetes with coronary heart disease.
8.Changes in the body shape and ergonomic compatibility for functional dimensions of desks and chairs for students in Harbin during 2010-2024
Chinese Journal of School Health 2025;46(3):315-320
Objective:
To analyze the change trends in the body shape indicators and proportions of students in Harbin from 2010 to 2024, and to investigate ergonomic compatibility of functional dimensions of school desks and chairs with current student shape indicators, so as to provide a reference for revising furniture standards of desks and chairs.
Methods:
Between September and November of both 2010 and 2024, a combination of convenience sampling and stratified cluster random sampling was conducted across three districts in Harbin, yielding samples of 6 590 and 6 252 students, respectively. Anthropometric shape indicators cluding height, sitting height, crus length, and thigh length-and their proportional changes were compared over the 15-year period. The 2024 data were compared with current standard functional dimensions of school furniture. The statistical analysis incorporated t-test and Mann-Whitney U- test.
Results:
From 2010 to 2024, average height increased by 1.8 cm for boys and 1.5 cm for girls; sitting height increased by 1.5 cm for both genders; crus length increased by 0.3 cm for boys and 0.4 cm for girls; and thigh length increased by 0.5 cm for both genders. The ratios of sitting height to height, and sitting height to leg length increased by less than 0.1 . The difference between desk chair height and 1/3 sitting height ranged from 0.4-0.8 cm. Among students matched with size 0 desks and chairs, 22.0% had a desk to chair height difference less than 0, indicating that the desk to chair height difference might be insufficient for taller students. The differences between seat height and fibular height ranged from -1.4 to 1.1 cm; and the differences between seat depth and buttock popliteal length ranged from -9.8 to 3.4 cm. Among obese students, the differences between seat width and 1/2 hip circumference ranged from -20.5 to -8.7 cm, while it ranged from -12.2 to -3.8 cm among non obese students.
Conclusion
Current furniture standards basically satisfy hygienic requirements; however, in the case of exceptionally tall and obese students, ergonomic accommodations such as adaptive seating allocation or personalized adjustments are recommended to meet hygienic requirements.
9.Differentiation and Treatment of Non-Obstructive Hypertrophic Cardiomyopathy Based on the Concept of Nourishing the Heart and Softening the Hardness
Xiaofei GENG ; Xinbiao FAN ; Xitong SUN ; Wenyu SHANG ; Wenxiu LI ; Chi ZHANG ; Junping ZHANG
Journal of Traditional Chinese Medicine 2025;66(8):846-850
This article summarized clinical experience in differentiating and treating non-obstructive hypertrophic cardiomyopathy (HCM) based on the concept of nourishing the heart and softening the hardness. It is considered that HCM belongs to the category of "heart accumulation", with the fundamental cause being depletion of the spleen and kidney, and phlegm-stasis accumulation, as well as qi-yin exhaustion, serving as the manifestations. Spleen and kidney depletion leads to the transformation of phlegm and stasis, which accumulate in the heart; over time, this phlegm-stasis accumulation consumes heart qi and yin, resulting in the heart being deprived of nourishment, which eventually leads to the damage to both the function and structure of heart. Therefore, the method of nourishing the heart and softening the hardness is proposed for the treatment of non-obstructive HCM. Emphasis is placed on softening hardness and dissipating masses throughout the entire treatment process, often using Modified Siwei Ruanjian Formula (四味软坚方加减). During periods with prominent symptoms, the main treatment is boosting qi and nourishing yin to soften hardness and dissipate masses with self-made Yuxin Ruanjian Formula (自拟育心软坚方) in modifications; in stable periods, the main treatment is boosting kidney and fortifying spleen to soften hardness and dissipate masses with self-made Pishen Tongzhi Formula (脾肾同治方) in modifications.
10.Effects of polylactic acid-glycolic acid copolymer/lysine-grafted graphene oxide nanoparticle composite scaffolds on osteogenic differentiation of MC3T3 cells
Shuangqi YU ; Fan DING ; Song WAN ; Wei CHEN ; Xuejun ZHANG ; Dong CHEN ; Qiang LI ; Zuoli LIN
Chinese Journal of Tissue Engineering Research 2025;29(4):707-712
BACKGROUND:How to effectively promote bone regeneration and bone reconstruction after bone injury has always been a key issue in clinical bone repair research.The use of biological and degradable materials loaded with bioactive factors to treat bone defects has excellent application prospects in bone repair. OBJECTIVE:To investigate the effect of polylactic acid-glycolic acid copolymer(PLGA)composite scaffold modified by lysine-grafted graphene oxide nanoparticles(LGA-g-GO)on osteogenic differentiation and new bone formation. METHODS:PLGA was dissolved in dichloromethane and PLGA scaffold was prepared by solvent evaporation method.PLGA/GO composite scaffolds were prepared by dispersing graphene oxide uniformly in PLGA solution.LGA-g-GO nanoparticles were prepared by chemical grafting method,and the PLGA/LGA-g-GO composite scaffolds were constructed by blending LGA-g-GO nanoparticles at different mass ratios(1%,2%,and 3%)with PLGA.The micromorphology,hydrophilicity,and protein adsorption capacity of scaffolds of five groups were characterized.MC3T3 cells were inoculated on the surface of scaffolds of five groups to detect cell proliferation and osteogenic differentiation. RESULTS AND CONCLUSION:(1)The surface of PLGA scaffolds was smooth and flat under scanning electron microscope,while the surface of the other four scaffolds was rough.The surface roughness of the composite scaffolds increased with the increase of the addition of LGA-g-GO nanoparticles.The water contact angle of PLGA/LGA-g-GO(3%)composite scaffolds was lower than that of the other four groups(P<0.05).The protein adsorption capacity of PLGA/LGA-g-GO(1%,2%,and 3%)composite scaffolds was stronger than PLGA and PLGA/GO scaffolds(P<0.05).(2)CCK-8 assay showed that PLGA/LGA-g-GO(2%,3%)composite scaffold could promote the proliferation of MC3T3 cells.Alkaline phosphatase staining and alizarin red staining showed that the cell alkaline phosphatase activity in PLGA/LGA-g-GO(2%,3%)group was higher than that in the other three groups(P<0.05).The calcium deposition in the PLGA/GO and PLGA/LGA-g-GO(1%,2%,and 3%)groups was higher than that in the PLGA group(P<0.05).(3)In summary,PLGA/LGA-g-GO composite scaffold can promote the proliferation and osteogenic differentiation of osteoblasts,and is conducive to bone regeneration and bone reconstruction after bone injury.


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