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15 July 2026, Volume 23 Issue 7 Previous Issue   

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Volume 23, Issue 7 Table of Contents 2026, 23(7): 0-0.  Abstract ( 91 )   PDF (484KB) ( 94 )   Related Articles | Metrics

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Drug pairs of traditional Chinese medicine against sepsis Wang Lu, Bai Yinglu, Zhang Yuwen, Xu Xiaolong, Liu Qingquan 2026, 23(7): 721-726.  DOI: 10.19803/j.1672-8629.20250563 Abstract ( 67 )   PDF (1248KB) ( 62 )   Objective To explore the therapeutic efficacy, pharmacological mechanisms, and clinical value of three herbal pairs (Radix et Rhizoma Rhei-Fructus Trichosanthis Radix Astragali-Radix Angelicae Sinensis Radix et Rhizoma Ginseng-Radix Ophiopogonis) in the staged intervention of sepsis based on the “herbal-syndrome correspondence” theory in order to provide new therapeutic strategies for treating sepsis with TCM. Methods Given the evolution of heat toxicity through stasis toxicity to deficiency of positive qi in the course of sepsis, Rhubarb and Fructus Trichosanthis were selected in the early stage to clear heat, remove toxins and drain heat from organs. In the progressive stage, Astragali and Angelicae Sinensis were used to activate blood circulation and enhance vital qi. In the late stage, Ginseng and Ophiopogon japonicus were used to consolidate vital qi and strengthen the root of qi and nourish yin. Results The three herbal pairs, Radix et Rhizoma Rhei-Fructus Trichosanthis, Radix Astragali-Radix Angelicae Sinensis, Radix et Rhizoma Ginseng-Radix Ophiopogonis could effectively inhibit inflammation, oxidative stress, apoptosis, and regulate immunity and coagulation through multi-targets and multi-channels, which might significantly alleviate the clinical symptoms of fever, chills, panic, shortness of breath, and impaired consciousness of patients, reduce the APACHEⅡand SOFA scores, and shorten hospital stay, and improve the survival of patients. Conclusion The paired herbal therapy based on the theory of “herbal-syndrome correspondence” can meet demands of sepsis treatment for “layered precision intervention” by inhibiting sepsis-induced inflammation, immune dysregulation, coagulation disorders, and multiple organ dysfunction at multiple points indifferent stages of the disease, offering a safe and effective approach. References | Related Articles | Metrics

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Research progress in the regulation of NF-κB signaling pathway by traditional Chinese medicine monomers and compound formulas in the treatment of sepsis-induced acute lung injury Zhang Shuo, Wang Jinghui, Zhou Feng, Bai Yinglu, Xu Xiaolong, Chen Tengfei, Liu Qingquan 2026, 23(7): 727-732.  DOI: 10.19803/j.1672-8629.20260115 Abstract ( 49 )   PDF (1248KB) ( 48 )   Objective To review the latest research findings on the regulation of the nuclear factor-kappa B (NF-κB) signaling pathway by traditional Chinese medicine (TCM) monomers and compound formulas in the treatment of sepsis induced acute lung injury (SALI), and to provide a reference for the prevention and treatment of SALI with TCM. Methods Literature on NF-κB, SALI, and the regulatory mechanisms of TCM that was published in 2015-2025 was retrieved from CNKI and PubMed databases. Such indicators as pathological damage to lung tissue, the wet-to-dry ratio, and inflammatory factors were observed before the data was analyzed. Results As a key inflammatory regulatory pathway, NF-κB was closely associated with the onset and progression of SALI when aberrantly activated. TCM monomers (such as baicalin and astragaloside Ⅳ) and compound formulas (such as Qingwen Baidu decoction) could reduce the release of pro-inflammatory cytokines, alleviate oxidative stress, regulate apoptosis and autophagy, and ameliorate SALI by regulating the NF-κB signaling pathway. However, current research was still facing such challenges as the lack of investigations into the mechanisms, large gaps between animal models and clinical applications, limited applicability of multi-omics technologies, and inadequate clinical translation. Conclusion TCM monomers and compound formulas have protective effects against SALI by regulating the NF-κB signaling pathway. However, more efforts should be devoted to studies on cross-talk between multiple pathways, optimization of modeling, promotion of multi-omics integration, and standardization of clinical research design in order to accelerate bidirectional bench-to-bedside translation of TCM in the treatment of SALI. References | Supplementary Material | Related Articles | Metrics

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Mechanisms of β-Sitosterol against sepsis-induced coagulopathy based on data mining and network pharmacology Li Yajing, Chen Tengfei, Wang Xuerui, Xu Xiaolong, Liu Qingquan 2026, 23(7): 733-738.  DOI: 10.19803/j.1672-8629.20250732 Abstract ( 47 )   PDF (2500KB) ( 53 )   Objective To explore the properties, flavors, and channel tropism of traditional Chinese medicines (TCMs) containing β-Sitosterol, and to study the potential molecular mechanisms of β-Sitosterol against sepsis-induced coagulopathy (SIC) by integrating network pharmacology and molecular dynamics (MD) in order to provide data for the prevention and treatment of SIC. Methods We screened TCMs containing β-Sitosterol and identified their potential targets via databases before analyzing the taste, property and meridian tropism of related herbs. SIC-related targets were retrieved from the GeneCards, OMIM, and TTD databases while the intersection of these targets was identified using Venny 2.1.0. Protein-protein interaction (PPI) networks were used to identify key targets, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Molecular docking was used to validate the affinity between β-Sitosterol and core targets, and molecular dynamics simulations were performed to evaluate the stability of β-Sitosterol binding to these targets. Results Data mining found that β-Sitosterol-containing TCMs were predominantly categorized as “heat-clearing” drugs, which were bitter in flavor and cold in nature and belonged to the liver meridian. A total of 14 intersection targets between β-Sitosterol and SIC were identified. Pathway enrichment analysis suggested that the underlying mechanisms involved the T-cell receptor signaling pathway and the FOXO signaling pathway. Molecular docking results showed strong binding affinity between β-Sitosterol and the core targets. MD simulations confirmed that β-Sitostero formed stable protein-ligand complexes with target proteins such as TNF and SHH. Conclusion This study finds that β-Sitosterol may exert therapeutic effects against SIC by targeting multiple proteins, including TNF and SHH, and modulating signaling pathways such as the T-cell receptor and FOXO. References | Supplementary Material | Related Articles | Metrics

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Protective effects and dose effects of Suhexiang pills against septic myocardial injury in mice Yang Zhuoya, Bai Yinglu, Yang Yumei, Geng Yuli, Xu Xiaolong, Liu Qingquan 2026, 23(7): 739-745.  DOI: 10.19803/j.1672-8629.20260510 Abstract ( 43 )   PDF (1984KB) ( 43 )   Objective To explore the protective effectsof Suhexiang pillsagainst septic myocardial injury induced by cecal ligation and puncture (CLP) in miceand dose-effect relationships in order to to provide data for interventionswith septic cardiomyopathyusing traditional Chinese medicine. Methods SPF male C57BL/6J mice were randomly divided into a sham operation group, model group, Suhexiang pill low dose group and high dose group (0.195, 0.39gdian·kg-1). A sepsis myocardial injury model was established using the CLP method. Ligation and fixation were performed under the connecting rod of the ileocecal junction, and a penetrating puncture was made with the 21 G needle. After modeling, the rats were intragastrically administrated for 7 consecutive days. The condition and 7-day survival rate of these mice were observed, the cardiac function parameters of echocardiography were detected, and the pathomorphology of myocardia and lung tissues was observed via HE staining. Results Compared with the sham operation group, the mice in the model group were depressed, weight gain was slow, and the 7-day mortality was 70%. The lactic acid level increased significantly, the left ventricular ejection fraction and short axis shortening rate decreased significantly while the ventricular end systolic volume and left ventricular systolic diameter increased. The myocardial fibers became disordered and dissolved, and the infiltration of inflammatory cells in lung tissue was pronounced. Compared with the model group, the general stateof the two dose groups of Suhexiang pills was improved, the acid-base imbalancecorrected, lactic acid contents reduced, survival rateincreasedsignificantly, cardiac function indexes improved and histopathological damage mitigated. A high dose had significant advantages in improving survival rate, reducing lactic acid levels and lessening tissue damage. Conclusions uhexiang pills have a marked protective effect against CLP-induced septic myocardial injury in mice by improving the internal environment of the whole body, enhancing cardiac function, reducing tissue damage and lowering mortality. The efficacy is dose-dependent. High-dose interventionsare more effective. References | Supplementary Material | Related Articles | Metrics

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Exploratory randomized controlled trial of Suhexiang Pills in the treatment of sepsis-related myocardial injury Yang Yumei, Bai Yinglu, Ding Maoyu, Xu Xiaolong, Chen Tengfei, Yang Siwen, Liu Qingquan 2026, 23(7): 746-752.  DOI: 10.19803/j.1672-8629.20260440 Abstract ( 27 )   PDF (1416KB) ( 42 )   Objective To explore the clinical efficacy and safety of Suhexiang pills in the treatment of sepsis-related myocardial injury (SRMI), and provide references for the integrated Chinese and Western medicine treatment of SRMI. Methods Patients with SRMI admitted to the ICU of Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, between August 2024 and December 2025 were enrolled before being evenly and randomly assigned to the control group and experimental group. The control group received routine Western medicine treatment while the experimental group was additionally given Suhexiang pills. The course of treatment was 7 days. Cardiac troponinⅠ (cTnⅠ), cardiac function indicators (LVEF, E/A and LVEDD), inflammatory indicators (CRP, PCT, NEUT and WBC), coagulation indicators (PLT, D-D, PT and APTT), and prognostic scores (SOFA, APACHE-Ⅱand 28-day mortality) were compared between the two groups before treatment and on the 3rd and 7th days of treatment. Results On the 3rd day of treatment, the serum levels of cTn Ⅰand CRP in the experimental group were significantly lower than those of the control group (P<0.05). On the 7th day of treatment, the LVEF and E/A ratio of the experimental group were significantly higher than those of the control group, but the levels of IL-6, TNF-α and APTT were markedly decreased(P<0.05). There were no statistically significant differences in disease severity scores or short-term prognostic indicators between the two groups after treatment (P>0.05). Conclusion The administration of Suhexiang pills combined with routine Western medicine treatment can effectively alleviate cardiomyocyte damage, improve cardiac systolic function, reduce inflammatory levels and optimize coagulation function with a favorable safety profile. References | Supplementary Material | Related Articles | Metrics

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Research progress in Mongolian medicine formulas for hypertensive cardiac injury Guo Yuting, Wei Minghui, Guo Ying, Dong Na, Xue Mingming 2026, 23(7): 753-756.  DOI: 10.19803/j.1672-8629.20260482 Abstract ( 37 )   PDF (1298KB) ( 46 )   Objective To summarize the current research on Mongolian medicine formulas for hypertensive cardiac injury and provide insights into the mechanisms of Mongolian medicine and future development of drugs with reference to related studies on traditional Chinese medicine. Methods Recent literature on hypertensive cardiac injury and Mongolian medicine formulas was reviewed. Representative Mongolian medicine formulas and related TCM evidence were analyzed in general and key pathological processes in particular, including cardiac hypertrophy, ventricular remodeling, myocardial fibrosis, inflammation, oxidative stress, and metabolic abnormalities. Results Hypertensive cardiac injury involved multiple pathological processes, such as cardiomyocyte hypertrophy, cardiac remodeling, abnormal fibrotic signaling, and metabolic disorders. Current studies suggested that representative Mongolian medicine formulas, such as Anshen Buxin Liuwei pills, Nutmeg-5, and Siwei Tumuxiang powder, might be effective at cardiomyocyte protection, cardiac remodeling, hypertensive myocardial hypertrophy, and metabolic regulation. These formulas might exert cardioprotective effects through anti-oxidative, anti-apoptotic, calcium homeostasis-regulating, mitochondrial protective, and metabolic network-modulating mechanisms. In comparison, studies on TCM formulas and their active components against hypertensive cardiac injury were more full-fledged and might provide useful references for mechanistic studies of Mongolian medicine formulas. Conclusion Mongolian medicine formulas can be potentially used in interventions with hypertensive cardiac injury. However, current evidence remains limited by insufficient direct studies, unclear pharmacodynamic material bases, inadequate validation of core targets, and a lack of high-quality clinical data. More effort should be devoted to multi-omics-based functional validation and high-quality clinical research to shed light on their pharmacodynamic basis and mechanisms of action. References | Related Articles | Metrics

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Mongolian medicine Siwei Tumuxiang powder ameliorates pressure overload-induced cardiac hypertrophy by regulating metabolic networks Guo Ying, Guo Yuting, Yin Dongjie, Ren Zhongjie, Dong Na, Wei Minghui, Lu Ziyu, Li Xiangming, Wang Minjie, Xue Mingming 2026, 23(7): 757-766.  DOI: 10.19803/j.1672-8629.20260168 Abstract ( 30 )   PDF (2284KB) ( 40 )   Objective To investigate the cardioprotective effects of the Mongolian medicine Siwei Tumuxiang powder (STP) against pressure overload-induced cardiac hypertrophy (POH) resulting from abdominal aortic constriction (AAC) in rats, and to explore its underlying mechanism using metabolomics. Methods Forty male Sprague-Dawley rats were randomly divided into four groups: sham-operated (Sham), model (Mod), STP (1.6 g·kg-1), and the positive control captopril (CAP) group (0.015 g·kg-1). Following AAC surgery, the rats received intragastric administration of the respective drug for four weeks. Cardiac function was recorded using echocardiography. Myocardial pathological changes were observed via Hematoxylin-Eosin and Masson staining. The expression levels of markers for cardiac hypertrophy and fibrosis were detected using RT-qPCR and Western blot. Untargeted metabolomics based on UPLC-Q-TOF/MS was employed in combination with weighted gene co-expression network analysis (WGCNA) to screen out key metabolites and pathways. Results Compared to the Mod group, STP inter-vention significantly reduced the anterior wall thickness (AWT) and posterior wall thickness (PWT), increased ejection fraction (EF) and fractional shortening (FS), thereby improving cardiac function in AAC rats. STP also mitigated myocardial cell edema, disordered fiber arrangement, and collagen deposition. Furthermore, STP downregulated the mRNA and protein expression levels of ANP, β-MHC, TGF-β, and Col-1. Metabolomics analysis identified five core metabolic modules closely associated with both the disease state and drug intervention, leading to the selection of 52 hub metabolites, 39 of which were closely correlated with the disease. KEGG pathway enrichment analysis revealed that these hub metabolites were primarily enriched in such pathways as riboflavin metabolism, caffeine metabolism, and linoleic acid metabolism. Conclusions TP exerts a significant protective effect against AAC-induced POH, which is closely associated with its ability to improve mitochondrial energy supply by regulating riboflavin metabolism, to maintain purine homeostasis by regulating caffeine metabolism, and to inhibit inflammation and fibrosis by inhibiting linoleic acid metabolism. This study highlights the multi-component, multi-target, and network-regulating properties of this Mongolian medicinal compound. References | Supplementary Material | Related Articles | Metrics

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Mechanisms of action of Siwei Tumuxiang powder against hypertensive myocardial hypertrophy in rats based on transcriptomics Wei Minghui, Liu Fangbing, Li Xiangming, Li Jianying, Zhang Jiaru, Yin Dongjie, Ren Zhongjie, Guo Ying, Wang Minjie, Xue Mingming 2026, 23(7): 767-774.  DOI: 10.19803/j.1672-8629.20250886 Abstract ( 30 )   PDF (2219KB) ( 43 )   Objective To investigate the mechanism by which Siwei Tumuxiang powder ameliorates hypertensive myocardial hypertrophy so as to provide a reference for clinical treatment. Methods A rat model of myocardial hypertrophy was established via abdominal aortic ligation. Transcriptomics technology and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were used. Eighteen Sprague-Dawley (SD) rats were randomly divided into three groups: the sham-operated group (Sham), the model group (Mod), and the Siwei Tumuxiang powder administration group (STP, 1.6 g·kg-1·d-1), with six rats in each. A model of hypertensive myocardial hypertrophy was constructed via abdominal aortic coarctation in the Mod and STP groups. The STP group was given STP solution by gavage at a dose of 1.6 g·kg-1·d-1, while the Sham and Mod groups received an equal volume of normal saline by gavage. After 8 weeks of feeding, echocardiography was used to evaluate the cardiac function of each group. Heart tissue sections were stained with HE and Masson to observe the pathological changes in the structure of myocardial tissue and the degree of myocardial fibrosis. Western blot was used to detect the expressions of hypertrophy-related proteins. Based on network pharmacology simulation, a component-target network map was constructed and pathway enrichment analysis was conducted to predict the potential biological pathways of Siwei Tumuxiang powder against hypertensive myocardial hypertrophy. RNA-Seq was used for sequencing to analyze the differentially expressed genes, which were subjected to GO and KEGG enrichment analysis. The expressions of target genes were verified by qPCR. Results Echocardiography showed that the AWT and PWT of the STP group were significantly reduced, while EF and FS were significantly increased. HE and Masson staining suggested that Siwei Tumuxiang powder could mitigate the disordered arrangement of myocardial cells, cell hypertrophy, inflammatory infiltration, and the appearance of obvious fibrotic areas around myocardial vessels and in myocardial tissue spaces. Western blot showed that the expressions of hypertrophy-related protein ANP and fibrosis-related protein COL-1 were inhibited. The results of network pharmacology indicated that the 150 main components in Siwei Tumuxiang powder might exert therapeutic effects against hypertensive myocardial hypertrophy through 124 potential core targets. RNA-Seq identified 1 168 differentially expressed genes between the Sham group and the Mod group, and another 47 between the Mod group and the STP group. There were 22 feedback expressed genes in the intersection, among which 3 differentially expressed genes were related to hypertensive myocardial hypertrophy: Hamp, Ndrg1, and Gfpt2. RT-qPCR showed that Siwei Tumuxiang powder could reverse the expressions of Hamp, Ndrg1, and Gfpt2 genes in the heart tissue of model rats of hypertensive myocardial hypertrophy. Conclusions iwei Tumuxiang powder can retard the occurrence and development of hypertensive myocardial hypertrophy by regulating Hamp, Ndrg1, and Gfpt2 genes through complement and coagulation cascade, PPAR signaling pathway, and cholesterol metabolism pathways. References | Supplementary Material | Related Articles | Metrics

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Effects of Heibu Ointment on the growth and mitochondrial apoptosis of keloid fibroblasts under hypoxia Ma Hui, Li Linchang, Zhang Tianlei, Chen Weiwen, Zheng Haiyun 2026, 23(7): 775-782.  DOI: 10.19803/j.1672-8629.20250922 Abstract ( 36 )   PDF (2607KB) ( 39 )   Objective To investigate the effects of Heibu ointment on the proliferation, migration, apoptosis and expressions of hypoxia-inducible factor-1α (HIF-1α), and key proteins of the mitochondrial apoptotic pathway in keloid fibroblasts (KFs) under hypoxic conditions. Methods A human KFs cell line was cultured and divided into the following groups: normoxia, hypoxia, and hypoxia treated with Heibu ointment at concentrations of 500, 250, 125, 62.5, and 31.25 μg·mL-1. After 24 hours of culture, the MTT assay was performed to evaluate the proliferation of KFs and to select the optimal concentration for subsequent experiments. The KFs were then regrouped into normoxia, normoxia + 125 μg·mL-1 extract, hypoxia, and hypoxia + 125 μg·mL-1 extract. MTT assay, flow cytometry, scratch wound assay, immunofluorescence, and Western blot were used to evaluate the effects of the extract on the proliferation, apoptosis, migration and HIF-1α expression of KFs, and on the protein levels of key mitochondrial apoptosis factors (Bax, Bcl-2, Caspase-3). Results Compared with normoxic conditions, hypoxia significantly enhanced KFs’ proliferation (P<0.01), suppressed apoptosis (P<0.01), and promoted cell migration (P<0.01) while upregulating both the fluorescence intensity and protein expression of HIF-1α (P<0.01). Within the mitochondrial apoptotic pathway, hypoxia downregulated the expression levels of Bax and Caspase-3 (P<0.01) while upregulating Bcl-2 expressions (P<0.01). Treatment with Heibu ointment inhibited KFs’ proliferation (P<0.01), increased the apoptosis rate (P<0.01), and reduced migratory capacity P<0.01) compared to the hypoxia alone group. Concurrently, this ointment decreased both HIF-1α fluorescence intensity and protein expressions (P<0.01), elevated the expression levels of Bax and Caspase-3, but lowered Bcl-2 expression (P<0.01). Conclusion Our findings indicate that Heibu ointment can exert anti-scarring effects by inhibiting proliferation/migration, inducing apoptosis, downregulating HIF-1α, and activating the mitochondrial apoptotic pathway in hypoxic KFs. References | Supplementary Material | Related Articles | Metrics

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Protective effects of Polyporus umbellatus polysaccharides against chemotherapy-related liver injury Zhang Yuanyuan, Hu Kaiyong, Zhang Min, Liu Min, Liu Dahui, Li Jinxin, Wang Qiwei, Peng Pei, Huang Qian 2026, 23(7): 783-789.  DOI: 10.19803/j.1672-8629.20250676 Abstract ( 23 )   PDF (2228KB) ( 39 )   Objective To investigate the protective effect of Polyporus umbellatus polysaccharides against chemotherapy-associated liver injury (CALI) in mice and the underlying mechanism and to evaluate its antitumor activity. Methods Male Kunming mice were selected and randomly divided into four groups using a random number table method: a normal control group, model group, Polyporus umbellatus polysaccharides group（100, 200 and 400 mg·kg-1）, and positive drug group. The model group was intraperitoneally injected with cisplatin, oxaliplatin, cisplatin combined with paclitaxel, and cisplatin combined with gemcitabine to establish models of mouse liver injury. Polyporus umbellatus polysaccharides and positive control drugs were administered via intragastric gavage. The protective effects against CALI were assessed by measuring serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, as well as hepatic malondialdehyde (MDA) contents, glutathione peroxidase (GSH-Px) activities, and total superoxide dismutase (T-SOD) activities. Additionally, the inhibitory effect of Polyporus umbellatus polysaccharides on cancer cell proliferation was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assay across three cancer types and nine different cell lines (liver cancer, colorectal cancer, and breast cancer). Results Polyporus umbellatus Polysaccharides significantly attenuated the chemotherapeutic drug-induced increase in serum ALT and AST levels (P<0.05), and significantly enhanced the activities of T-SOD and GSH-Px while reducing the MDA content in liver tissues (P<0.05). The inhibitory effects of Polyporus umbellatus polysaccharides on the proliferation of tested cancer cells were both dose- and time-dependent, with particularly notable effects observed in hepatocellular carcinoma cells Huh7 (IC50=2.82 mg·mL-1 at 96 h) and MHCC97H (IC50=0.90 mg·mL-1 at 96 h). Conclusion These findings suggest that Polyporus umbellatus polysaccharides inhibit tumor cell proliferation and protect against CALI through an antioxidant mechanism. This dual-effect property offers a novel strategy for the prevention and treatment of CALI. References | Supplementary Material | Related Articles | Metrics

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A detection method for 37 types of bile acids in multiple matrices of hepatoenteric circulation of rats using UPLC-MS/MS technology Wang Qi, Yang Yanrong, Hou Tianyu, Li Yanyi, Wen Hairuo, Ning Xiao 2026, 23(7): 790-796.  DOI: 10.19803/j.1672-8629.20260264 Abstract ( 29 )   PDF (1441KB) ( 41 )   Objective To establish and validate a high-throughput quantitative method for determination of the contents of 37 types of bile acids in six types of matrices of rats based on ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) in order to provide a reference for investigating drug-induced liver injury and hepatenteric microecological mechanisms. Methods A porous activated carbon adsorption method was employed to prepare blank matrices, which were used to correct endogenous background interference in complex matrices in combination with internal standards. A pre-cooled acetonitrile one-step protein precipitation extraction method was adopted to inhibit intestinal microbiota-mediated in vitro enzymatic degradation. The HSS T3 chromatographic column was used to improve the retention of components of polar bile acids to facilitate the baseline separation of murine-specific isomers. Given the difficult fragmentation of the steroid core of free-type secondary bile acids, a pseudo multi-reactor monitoring mode with low collision energy (4-5 V) was optimized to enhance the sensitivity and specificity of detection. Results The 37 types of bile acids showed good linear relationships at the concentrations ranging from 0.09 to 3.60 μg·mL-1 (r²≥0.995 2). The detection limit was 0.43-29.86 ng·mL-1 while the quantification limit was 1.44-99.53 ng·mL-1. In the six matrices, the recovery rates at high, medium, and low concentrations ranged from 80.17% to 123.06%. After matrix matching correction using activated carbon, the matrix effect was 85.22%-114.75%. The relative standard deviation of both intra-day and inter-day precisions was 18.49% or less, with the accuracy meeting the requirements in guidelines for quantitative analysis of biological samples. Conclusion The multi-matrix UPLC-MS/MS method established in this study is highly specific, sensitive and reproducible. Based on synergistic optimization of sample pretreatment and chromatography-mass spectrometry conditions, this method can effectively address the key bottlenecks in targeted analysis of bile acids and is applicable to large-scale studies on cross-matrix pharmacovigilance and toxicological metabolic profiling. References | Supplementary Material | Related Articles | Metrics

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Liver injury caused by Dictamnus Root Bark based on data mining Hu Kexuan, Song Yagang, Wu Xiangxiang, Miao Mingsan 2026, 23(7): 797-801.  DOI: 10.19803/j.1672-8629.20250792 Abstract ( 50 )   PDF (1223KB) ( 62 )   Objective To investigate the causes of toxicity of Dictamnus Root Bark so as to provide a reference for rational medication. Methods Data mining technology was employed to screen 35 widely circulated and widely recognized works on herbal medicine and formulas published between the Han Dynasty and the Qing Dynasty, followed by the retrieval and in-depth analysis of literature on Dictamnus Root Bark. For research on modern literature, keywords including “Dictamnus Root Bark”, “toxicity”, “toxic” and “toxicology” were used to search for literature related to the medication safety of Dictamnus Root Bark published between 2003 and 2025. The results were analyzed in terms of herbal medicine, formulas, modern pharmacological effects, and toxicity of Dictamnus Root Bark. Results Dictamnus Root Bark was cold in nature and bitter in taste, belonging to the meridians of the small intestines, stomach, and urinary bladder, and thus should not be used among patients with deficiency-cold syndrome in lower limbs. In clinic, Dictamnus Root Bark was mostly administered orally as a decoction at a dose of 4-10 g, with Glycyrrhizae Radix et Rhizoma and Scutellariae Radix serving as the preferred compatible medicinal materials for attenuating toxicity and enhancing efficacy. The components responsible for liver injury were dictamnine and limonin. Excessively high dosage or long-term successive administration was likely to induce liver injury. The aqueous decoction of Orychophragmus violaceus seeds (a herbal medicine) and sulfhydryl reagents including glutathione and N-acetylcysteine could effectively mitigate acute liver injury induced by Dictamnus Root Bark. Conclusion Toxic reactions caused by Dictamnus Root Bark are chiefly triggered by inappropriate compatibility, excessively high dosage, and prolonged administration. Adverse reactions can be prevented by controlling the germplasm resources of the medicinal material, adopting appropriate compatibility schemes, selecting rational forms, and regulating the dosage. References | Supplementary Material | Related Articles | Metrics

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Association between perioperative potentially inappropriate medication and short-term adverse postoperative outcomes in elderly patients Xu Ling, Li Jiajie, Li Xin, Gu Kai 2026, 23(7): 802-808.  DOI: 10.19803/j.1672-8629.20260218 Abstract ( 48 )   PDF (1406KB) ( 59 )   Objective To analyze the association between perioperative PIM exposure levels and postoperative complications in order to provide evidence for decision-making regarding precise medication interventions and optimization of surgical quality management in elderly patients. Methods A single-center retrospective cohort design was employed. Patients ages 65 and older undergoing elective non-cardiac surgery at a hospital in Nanjing between December 2022 and March 2025 were included. Perioperative PIMs were evaluated based on the Beers criteria, and short-term exposure evaluation indicators were established. The outcome referred to the occurrence of complications within 30 days postoperatively. Multivariable logistic regression analysis was conducted to examine the impact of preoperative and intraoperative PIM exposure on the risk of postoperative complications. Results A total of 696 patients were enrolled in this study, 284 of whom (40.80%) were exposed to PIMs preoperatively. Postoperative complications within 30 days occurred in 154 patients (22.13%) of the entire cohort. Multivariable logistic regression analysis found that preoperative PIM exposure was a significant contributor to postoperative adverse drug reactions [Odds Ratio (OR)=1.651, P=0.019]. An increase in preoperative PIM exposure levels was associated with an incremental risk of overall postoperative complications (OR=1.277, P=0.012). In addition, 238 patients (34.20%) were exposed to PIMs both preoperatively and intraoperatively. Interaction analysis indicated that combined preoperative-intraoperative PIM exposure had a synergistic effect on the risk of postoperative complications, with a more significant impact than exposure during either period alone (OR=6.585, P= 0.003). Conclusion Preoperative PIM exposure is common among elderly surgical patients and associated with an increased risk of postoperative complications. Additional intraoperative PIM exposure can exacerbate the negative impact on postoperative recovery. Routine and dynamic monitoring of perioperative PIMs is conducive to prognostic risk stratifi-cation and may serve as a potential intervention target for improving postoperative outcomes. References | Supplementary Material | Related Articles | Metrics

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982 cases of cutaneous adverse drug reaction in children Wu Guanghua, Xing Yabing, Zhang Shengnan, Wang Juping, Chen Xiaobo, Xia Xudong 2026, 23(7): 809-813.  DOI: 10.19803/j.1672-8629.20250226 Abstract ( 99 )   PDF (1298KB) ( 91 )   Objective To investigate the prevalence and clinical characteristics of cutaneous adverse drug reactions (CADRs) in pediatric patients, and to give evidence-based recommendations for safe medication and rational drug use. Methods A retrospective analysis was conducted of 982 cases of CADRs reported by the Children’s Hospital Affiliated to Zhengzhou University between January 2018 and December 2024. The data collected included demographics (age and gender), clinical manifestations, culprit medications, latency periods, systemic organ involvement, therapeutic interventions, and clinical outcomes. Results Among the 982 cases of CADRs, 586 involved males, and the majority were observed in the group aged 2-11. Exanthematous drug eruptions were the dominating mild manifestations, and severe reactions included drug hypersensitivity syndrome, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Anti-infective drugs, respiratory medications, and antiepileptic drugs were identified as the predominant causative agents. Among these cases, 712 underwent symptomatic treatment with antihistamines, topical/systemic steroids, and glycerite lotion. Most of the patients achieved favorable outcomes, Most of the patients achieved favorable outcomes, while the prognosis remained unknown in 11 cases. Conclusion CADRs are usually mild in children, but some cases may progress to severe CARDs. Clinicians should give pharmaceutical care during treatment to ensure the safety of drug use. References | Related Articles | Metrics

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One case of convulsions and dyspnea caused by piperacillin sodium and tazobactam sodium for injection Liu Lina, Zhang Fengqin, Yang Fan, Liu Yuan 2026, 23(7): 814-816.  DOI: 10.19803/j.1672-8629.20250425 Abstract ( 59 )   PDF (1185KB) ( 64 )   Objective To analyze the cause of convulsions accompanied by dyspnea induced by piperacillin sodium and tazobactam sodium for injection so as to provide a reference for safe clinical medication. Methods One case of serious adverse reactions in an AECOPD patient during treatment was retrospectively analyzed, and clinical manifestations and treatment regimens were summarized. Results Correlation analysis suggested that the adverse reaction of convulsions accompanied by dyspnea in this patient was definitively associated with the piperacillin sodium and tazobactam sodium injection. After discontinuation of piperacillin sodium and tazobactam sodium injection and effective treatment with cefoperazone sodium and sulbactam sodium injection, the patient’s symptoms were relieved. Conclusion Piperacillin sodium and tazobactam sodium injection may induce convulsions by antagonizing the γ-aminobutyric acid (GABA) receptors, which is common in patients with renal insufficiency or when overdose occurs. Clinicians should be alert to such adverse neurological events to ensure safe medication. References | Related Articles | Metrics

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One case of airway spasm caused by rocuronium bromide injection Qian Xia, Guo Zhigang, Zheng Liguang 2026, 23(7): 817-819.  DOI: 10.19803/j.1672-8629.20250652 Abstract ( 49 )   PDF (1140KB) ( 55 )   Objective To investigate the characteristics of such adverse reactions as airway spasm induced by rocuronium bromide injection, and to provide a reference for safe medication. Methods One case of intraoperative airway spasm caused by rocuronium injection in an 8-year-old patient was analyzed. Based on literature, the related adverse reactions and possible mechanisms were studied while treatment regimens were recommended. Results After discontinuation of the drug and symptomatic treatment, the patient gradually improved. By reviewing drug instructions and literature, it was found that the correlations between rocuronium bromide injection and airway spasm were “possible”. Conclusion During clinical anesthesia, the risk of airway spasm caused by rocuronium bromide injection deserves attention to ensure the safety of patients. References | Related Articles | Metrics

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One case of gastrointestinal hemorrhage caused by amphotericin B cholesteryl sulfate complex for injection Yang Yajing, Yang Lu, Huang Na, Fu Yuhao, Shen Yanhong 2026, 23(7): 820-822.  DOI: 10.19803/j.1672-8629.20250895 Abstract ( 44 )   PDF (1143KB) ( 53 )   Objective To study the association of gastrointestinal bleeding with amphotericin B cholesteryl sulfate complex for injection(ABCD) and potential mechanisms during the treatment of pulmonary mucormycosis in order to provide references for monitoring of clinical safety. Methods A retrospective analysis was conducted of an elderly patient with invasive pulmonary mucormycosis who had developed gastrointestinal bleeding after receiving ABCD. Such databases as Wanfang, CNKI, and PubMed were searched for reports on adverse reactions related to ABCD. Causality was evaluated using both the criteria stipulated by the National Adverse Drug Reaction Monitoring Center and the Naranjo Adverse Drug Reaction Probability Scale. Results The patient presented with fresh hematochezia on the sixth day of ABCD therapy. Symptoms were resolved after discontinuation of ABCD and hemostatic treatment, with no recurrence. Causality assessment indicated a “probable” association between ABCD and the gastrointestinal bleeding event. Conclusion Although ABCD can reduce the nephrotoxicity associated with conventional amphotericin B, its potential risk of inducing gastrointestinal bleeding warrants attention, particularly in elderly patients with multiple underlying conditions. References | Related Articles | Metrics

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One case of extremely severe thrombocytopenia caused by niraparib tosilate capsules Jin Xiaoqian, He Zhijie 2026, 23(7): 823-825.  DOI: 10.19803/j.1672-8629.20260261 Abstract ( 41 )   PDF (1260KB) ( 51 )   Objective To investigate a case of extremely severe thrombocytopenia induced by niraparib tosilate capsules and to provide a reference for its safe clinical use. Methods One case of extremely severe thrombocytopenia after taking niraparib was analyzed, and the causes of thrombocytopenia and clinical management strategies were reviewed based on related literature. Results Based on a correlation evaluation, the patient’s extremely severe thrombocytopenia was believed to have been caused by niraparib. After discontinuation of the drug and symptomatic treatment, the platelet count returned to normal and bleeding symptoms were resolved. Conclusion Niraparib may cause severe thrombocytopenia during clinical use. Routine monitoring with complete blood counts is recommended during treatment. If a significant decrease in platelet count occurs or bleeding-related symptoms are observed, the drug should be discontinued immediately and appropriate treatments offered to ensure patients’ safety and prevent serious adverse reactions. References | Related Articles | Metrics

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One case of severe hepatotoxicity caused by fulzerasib tables Jiang Wei, Hou Kaifeng, Xu Lei, Ding Li, Xu Yingying, Ge Hailin, Wang Junping, Jiang Jiemei 2026, 23(7): 826-828.  DOI: 10.19803/j.1672-8629.20260143 Abstract ( 47 )   PDF (1182KB) ( 58 )   Objective To investigate the risk factors, potential mechanisms and therapeutic strategies related to drug-induced liver injury (DILI) caused by fulzerasib tablets so as to provide references for safe clinical medication. Methods One case of advanced non-small cell lung cancer treated with fulzerasib tablets was analyzed, DILI induced by targeted drugs was identified, and the pathogenesis and targeted therapeutic strategies were explored. Results The patient developed severe cholestatic DILI after treatment with fulzerasib tablets. Causality assessment suggested the association with fulzerasib was “probable”. After drug discontinuation and hepatoprotective and cholagogic treatment, the patient’s indicators of liver function were significantly improved. Conclusion Risk factors for hepatotoxicity during clinical use of antineoplastic drugs deserve attention. In case of adverse reactions of DILI, quick drug withdrawal and symptomatic treatment are critical. References | Related Articles | Metrics

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Research progress in signal pathways of traditional Chinese medicine in anti-liver fibrosis Zhang Chenlu, Li Mingqi, Wang Yinghe, Ma Yuehong 2026, 23(7): 829-834.  DOI: 10.19803/j.1672-8629.20260072 Abstract ( 37 )   PDF (1437KB) ( 47 )   Objective To investigate the multi-target and multi-pathway intervention mechanisms of traditional Chinese medicine (TCM) monomers and compound formulas in the treatment of hepatic fibrosis in order to provide data for efforts to overcome the limitations of single-target Western medicine therapy. Methods Research papers on TCM against hepatic fibrosis published in recent years were retrieved and reviewed. The main signaling pathway networks with interventions by TCM (including TGF-β/Smad, PI3K/Akt, NOX4/ROS, MAPK, JAK/STAT3, NF-κB, Notch, Wnt/β-Catenin, etc.) were summarized. The characteristics and molecular mechanisms of “multi-target, multi-pathway, and multi-link” synergistic regulation were analyzed. Results TCM could simultaneously intervene in key signaling networks of hepatic fibrosis via multiple therapeutic effects, such as inhibition of hepatic stellate cell (HSC) activation, blockade of collagen deposition, promotion of matrix degradation, and induction of HSC apoptosis, which gave TCM advantages in reversing early-stage fibrosis. Conclusion More research should be devoted to the precise identification of active components and target validation of TCM against hepatic fibrosis while compatibility strategies are to be optimized based on modern omics technologies and network pharmacology so as to contribute to precise prevention and treatment of hepatic fibrosis. References | Related Articles | Metrics

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Research progress in pharmacological mechanisms and clinical applications of trimetazidine Huo Hongmin, Yang Yaofang, Jiang Lianghua, Mao Zixian, Wang Xiaoying, Hu Ping 2026, 23(7): 835-840.  DOI: 10.19803/j.1672-8629.20250904 Abstract ( 36 )   PDF (1338KB) ( 48 )   Objective To explore the pharmacological effects, clinical applications and association of trimetazidine with Parkinson’s syndrome in order to provide a reference for safe and rational use of the drug. Methods Literature about experiments on and clinical use of trimetazidine in the past five years was retrieved to find out more about the pharmacological effects and clinical applications of trimetazidine. The possible mechanisms through which trimetazidine was involved in Parkinson’s syndrome were explored. Results The latest research found that trimetazidine could deliver anti-apoptosis, antioxidant, anti-pyroptosis and anti-inflammation effects while regulating autophagy and metabolism, suggesting that it could be used in the treatment of acute ST-segment elevation myocardial infarction, chronic heart failure, viral myocarditis and severe pneumonia. Parkinson’s syndrome was linked to autophagy dysfunction, necroptosis pathway, mitochondrial dysfunction, and epigenetic modifications. Conclusion The pharmacological effects of trimetazidine have been summarized. This drug combats a range of diseases while inducing Parkinson’s syndrome through multi-targets and multi-pathways. This study is expected to provide evidence for subsequent studies on the related mechanisms and disease-inducing factors. References | Related Articles | Metrics

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Risk of altered skin sensations caused by glucagonlike peptide-1 (GLP-1) receptor agonists 2026, 23(7): 834-834.  DOI: 10.19803/j.1672-8629.20269907 Abstract ( 66 )   PDF (743KB) ( 61 )   Related Articles | Metrics